Procedural Sedation

Bottom line recommendations for the procedural sedation - French. Published online: March 2018.

Bottom line recommendations for pediatric procedural sedation. Published online: March 2018.

Bottom line recommendations for the procedural sedation - French. Published online: March 2018.

This report was developed through a collaborative effort of the American Academy of Pediatrics and the American Academy of Pediatric Dentistry to offer pediatric providers updated information and guidance in delivering safe sedation to children.

This clinical policy from the American College of Emergency Physicians is the revision of a 2005 clinical policy evaluating critical questions related to procedural sedation in the emergency department.

This video describe procedural sedation and analgesia for children. Published: April 2014.

This update of an evidence-based clinical practice guideline critically discusses indications, contrindications, personnel requirements, monitoring, dosing, coadministered medications, recovery issues, and future research questions for ketamine dissociative sedation.

This clinical guideline covers the assessment, preparation, training and monitoring needed when using sedation in people under the age of 19. The aim is to help healthcare professionals decide when sedation is the most clinically and cost effective option for reducing pain and anxiety during operations for children and young people.

This report was developed through a collaborative effort of the American Academy of Pediatrics and the American Academy of Pediatric Dentistry to offer pediatric providers updated information and guidance in delivering safe sedation to children.

This overview of systematic reviews examines the safety and efficacy of sedative agents commonly used for procedural sedation (propofol, ketamine, nitrous oxide, midazolam) in children in the ED or similar settings.

Evidence suggests ketamine can be administered intranasally. This study reviews the evidence for intranasal ketamine for procedural sedation and analgesia in children.

This review provides an update on pharmacological techniques for procedural sedation for children outside the operating room.

The aim of this review was to investigate the safety and efficacy of nitrous oxide during brief, but painful paediatric procedures and to compare nitrous oxide with some of the commonly used pharmacological and non-pharmacological treatments for relieving anxiety and mild to moderate pain in Denmark.

This review investigated existing evidence to determine whether ketamine should be best administered intravenously or intramuscularly.

This review investigated which skills and competence were imperative to assure optimal effectiveness and safety of procedural sedation (PS) in children and analyzed the underlying levels of evidence.

Ketamine is widely used in emergency departments (EDs) to facilitate painful procedures; however, existing descriptors of predictors of emesis and recovery agitation are derived from relatively small studies.

Although ketamine is one of the most commonly used sedatives to facilitate painful procedures for children in the emergency department (ED), existing studies have not been large enough to identify clinical factors that are predictive of uncommon airway and respiratory adverse events.

This review assessed the safety and efficacy of various forms of analgesia and sedation for fracture reduction in pediatric patients in the emergency department, as observed in randomized controlled trials in pediatric populations.

This document is a clinical policy on pediatric procedural sedation.

This study evaluated aspiration episodes and a combined outcome of major adverse events (aspiration, death, cardiac arrest, or unplanned hospital admission) with respect to NPO status, American Society of Anesthesiologists physical status, age, propofol use, procedure types, and urgency of the procedure.

This study aims to describe the characteristics of and predictors for apnea and clinical interventions during emergency department (ED) procedural sedation.

The aim of this study was to determine the safety and the efficacy of paediatrician-administered propofol in children undergoing different painful procedures.

This study aimed to describe the frequency of different physiologic monitoring modalities and combinations of modalities used during pediatric procedural sedation and to describe the variations of monitoring and whether or not sedations meet monitoring guidelines.

This study compared total sedation time when ketamine/ propofol was used compared with ketamine alone for pediatric procedural sedation and analgesia.

This study aims to delineate the nature and frequency of adverse events associate with propofol-based sedation/anesthesia care using prospectively collected data on pediatric sedation/anesthesia outside the operating room (OR).

This study investigated the effect of ondansetron on the incidence of vomiting in children who received intravenous (IV) ketamine for procedural sedation and analgesia in the emergency department (ED).

The objective of this study was to compare the efficacy of etomidate and midazolam for achieving procedural sedation and analgesia in children.

This study compared adverse events, efficacy, and length of sedation of intravenous (i.v.) versus intramuscular (i.m.) ketamine procedural sedation and analgesia for orthopedic procedures in the emergency department (ED).

The objective of this study was to use a large database of prospectively collected data on pediatric sedation and/or anesthesia for diagnostic and therapeutic procedures to delineate the nature and the frequency of adverse events that are associated with sedation/anesthesia care for procedures that are performed outside the operating room in children.

The aims of this study were to report the experience of using intramuscular ketamine 2.0 or 2.5 mg/kg for minor painful procedures in children in a medium sized district general hospital accident and emergency department, and to demonstrate the safety and acceptability of ketamine and determine if the incidence of adverse effects is related to dose or other variables.

The aim of the study was to investigate whether pretreatment with ketamine would reduce infusion line pain in propofol sedation in children.

This study compared the effectiveness of 2 medication regimens, propofol/fentanyl (P/F) and ketamine/midazolam (K/M), for brief orthopedic emergency department procedural sedation.

This study compared intranasal midazolam (INM) with a combination of intravenous ketamine and intravenous midazolam (IVKM) for sedation of children requiring minor procedures in the emergency department.

This study compared the efficacy and complication profile of oral midazolam therapy and continuous-flow 50% nitrous oxide in alleviating anxiety during laceration repair in children 2 to 6 years old.

This study characterized the nature and severity of recovery agitation after ketamine sedation in children treated in the emergency department and determined whether the addition of adjunctive midazolam reduced the magnitude of such recovery agitation.

This study was conducted to investigate the frequency and severity of adverse effects, specifically emergence phenomena, experienced by patients receiving intravenous ketamine with or without midazolam for sedation in a pediatric emergency department.

Emergency management of pediatric fractures and dislocations requires effective analgesia, yet children's pain is often undertreated. This study compared the safety and efficacy of fentanyl- versus ketamine- based protocols.

This study aimed to determine whether administration of nitrous oxide, 50% and 70%, could provide analgesia and anxiolysis during venous cannulation in pediatric patients.

Episode 76: Join Dr. Amy Drendel, a world leader in pediatric pain management and procedural sedation research, as she discusses how best to manage pain and anxiety in three situations in the ED: the child with a painful fracture, the child who requires imaging in the radiology department and the child who requires a lumbar puncture.

Published online: February 2016

Pain Assessment and Management Initiative (PAMI) is an e-Learning and patient safety educational project funded through a grant by the Florida Medical Malpractice Joint Underwriting Association. The overall goal of PAMI is to improve the safety of patients of all ages by developing tools and learning modules for health care providers to recognize, assess, and manage acute and chronic pain in acute care settings such as the Emergency Department. The tools and resources developed are designed to be used, adapted and implemented by any health care facility or agency based on their specific needs. The PAMI site also includes pain related resources, apps/podcasts and learning modules. PAMI learning modules and materials are developed by a state and national expert panel and are multidisciplinary, targeting physicians, nurses, PAs, pharmacists, paramedics, hospital patient safety officers, risk managers and other providers.