Procedural Sedation by Pediatric Hospitalists: Analysis of the Nature and Incidence of Complications During Ketamine and Nitrous Oxide Sedation

Srinivasan, Mythili; Carlson, Douglas W.

doi:10.1542/hpeds.2013-0025

Cited by 12 publications

(3 citation statements)

References 16 publications

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“…In-hospital sedation in the academic setting tends to be more common. The increased risk with higher ASA status is consistent with prior published studies [5,13,48,49]. The findings of higher risks between 6 pm and 6 AM and for those sedations which were for emergent procedures have not previously been reported and warrant further investigation.…”

Section: Discussionsupporting

confidence: 90%

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Mason

Roback

Chrisp

et al. 2019

JCM

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Background: The incidence of sedation-related adverse events, inclusive of both adults and children, administered by multiple specialty providers from different countries and venues, using standardized definitions, has never been reported on an international level. We are reporting the outcome data of the adverse event sedation reporting tool as an important step toward a more complete risk assessment of sedation-related morbidity, mortality, and etiology. The analysis of the AE sedation reporting data include descriptive measures to evaluate the characteristics of the provider, the patient, sedations performed, adverse events, interventions, and outcomes. The primary outcome was the rate and nature of adverse events. Between 12/14/2010 and 12/11/2018 there were 7952 sedations, from an estimated total of 164,114 sedations administered, of which 622 were reported as adverse events. The mean age of the entire patient population is 33.0 years (0.02-98.7). The providers represented 39 countries across six continents. Oxygen desaturation (75%-90%) for <60 s is the most prevalent adverse event with a rate of 7.8 per 10,000, followed by airway obstruction at a rate of 5.42 per 10,000. Apnea occurred at a rate of 4.75 per 10,000. Significant predictors of adverse events are ≥ ASA score III (p = 0.0003), procedure time (6:00 pm-12:00 am: p < 0.0001, 12:00-6:00 am: p = 0.0003), and non-hospital location (p < 0.0001). The AE sedation reporting tool has demonstrated that the majority of adverse events in children and adults who receive procedural sedation from multi-specialists internationally required minor interventions and had outcomes of minor risk.

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Section: Discussionsupporting

confidence: 90%

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Mason

Roback

Chrisp

et al. 2019

JCM

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“…Benzodiazepin (midazolam) %63,5 oranında uygulanmıştı. Premedikasyonda uygulanan klasik ilaç ve dozların yanında literatüre yeni giren araştırmalarda deksmedetomidin infüzyonları, nazal klonidin uygulamaları, smartphone ile çocuğu meşgul etme yöntemleri bildirilmektedir [5][6][7][8] . Kliniğimizde de çocukları bu dönemde meşgul etmek için çeşitli yöntemler denenmektedir.…”

Section: Bulgularunclassified

Anesthesia and Analgesia Methods that We Used on Pediatric Patients

Başkan¹,

Kayar²,

Gamlı³

et al. 2018

Kafkas J Med Sci

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“…Both parents and patients reported less pain during procedure with N 2 O. 66,67 A clinical survey on 111 pediatric emergency physicians revealed that N 2 O and ketamine were most commonly used in PS for FR. 68 The effect of N 2 O on ventilation is dose-dependent.…”

Section: Common Procedural Sedation Agents Used For Fracture Reductiomentioning

confidence: 99%

Procedural Sedation for Orthopedic Fracture Reductions in the Pediatric Emergency Department

Bal¹,

Hennes²

2016

cayd

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To provide an updated literature review on pediatric procedural sedation in the emergency department. Discuss patient evaluation, monitoring, indications, and contraindications of common pharmacologic agents used for procedural sedation during orthopedic fracture reductions in the pediatric emergency department. Literature search from 1995 to 2015 was conducted using MEDLINE (PubMed), CINAHL, Cochraine and EMBASE databases. Terms included; procedural sedation, fracture reduction, orthopedic reduction, fasting, monitoring, capnometry, Bispectral index and pediatric procedural sedation. We identified a total of 1268 publications covering the literature search criteria listed above. Twenty-two studies evaluated procedural sedation for reduction of closed skeletal injuries in the pediatric emergency department (eight retrospective case series, five prospective case series and nine randomized controlled clinical trials). The published literature utilized different pain assessment scales, pharmacologic agents, and satisfaction evaluation methodology. Ketamine alone or in combination with midazolam was the most common sedation agent used in the published literature. The use of procedural sedation for performing painful procedures in the pediatric emergency department is common. Ketamine and nitrous oxide are the most commonly used pharmacologic agents. Both agents have an excellent safety profile when published sedation guidelines are followed. Patient monitoring is the single most critical element for providing safe sedation in the emergency department. There are several adjuncts for providing safe and effective sedation in the emergency department including capnography, Ramsay sedation scale, Bispectral index, and aldrete score.

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Procedural Sedation by Pediatric Hospitalists: Analysis of the Nature and Incidence of Complications During Ketamine and Nitrous Oxide Sedation

Abstract: PH at St Louis Children's Hospital successfully provided sedation by using ketamine and N2O with low rates of complications for a variety of procedures.

Cited by 12 publications

References 16 publications

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Anesthesia and Analgesia Methods that We Used on Pediatric Patients

Procedural Sedation for Orthopedic Fracture Reductions in the Pediatric Emergency Department

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