Sedation for pediatric diagnostic imaging: use of pediatric and nursing resources as an alternative to a radiology department sedation team

Abstract

Implementing a pediatric sedation pathway significantly decreases the sedation failure rate. Pediatric residents and nurses can safely, effectively and efficiently sedate pediatric patients for routine diagnostic imaging procedures without the need for a radiology department sedation team in a department with a small-to-moderate volume of pediatric patients.

Professional Skills and Competence for Safe and Effective Procedural Sedation in Children: Recommendations Based on a Systematic Review of the Literature

“…Several authors have shown that the introduction of a dedicated PS team that works according to published guidelines results in a significant decrease of procedural failure ( Level 2 conclusion based on Hoffman et al 2002(B), Ruess et al 2002(C), and Sury et al 1999(C)) [13, 15, 64]. Although it is impossible to deduce from those studies to what extent this result is due to specific professional skills and competence, PS seems to become more effective when specifically trained professionals perform PS in accordance with international guidelines.…”

“…The adoption of a uniform and systematic practice is associated with a significant reduction in adverse events during anesthesia [11]. Similarly, there is strong evidence that implementation of published guidelines leads to safer and more effective PS [12–15]. …”

Adverse Cardiovascular and Respiratory Events during Sedation of Pediatric Patients for Imaging Examinations

“…Having sedatives administered by personnel who are experienced in pediatric sedation and certified in pediatric advanced life support ensures safe and effective IV sedation in children (21,22). In addition, nonanesthesiologists who administer sedatives should be fully trained in the physiology of sedation and in the pharmacology of sedatives and analgesics (20,23,24).…”

Sedation and anesthesia for magnetic resonance imaging in pediatric patients: is dexmedetomidine the answer?

“…Historically, pediatric radiologists have administered their own sedation using relaxation techniques or medications such as chloral hydrate. 5,6 Other sedation medications, such as phenobarbital, fentanyl, midazolam, and ketamine, 7 have also been used by both sedation-trained nurses and physicians. However, when traditional sedation techniques have failed, pediatric anesthesiologists have been consulted and have become more involved in providing sedation/anesthesia for radiological studies, as well as in developing sedation and anesthesia protocols for infants.…”