Procedural sedation programme minimising adverse events: a 3-year experience from a tertiary paediatric emergency department
Author | Erumbala, Gokul |
Author | Anzar, Sabu |
Author | Deiratany, Samir |
Author | Blackie, Barbara |
Author | Powell, Colin |
Author | Al Ansari, Khalid |
Available date | 2024-07-27T11:25:58Z |
Publication Date | 2023-09-29 |
Publication Name | Archives of Disease in Childhood |
Identifier | http://dx.doi.org/10.1136/archdischild-2023-326021 |
Citation | Erumbala, G., Anzar, S., Deiratany, S., Blackie, B., Powell, C., & Al Ansari, K. (2024). Procedural sedation programme minimising adverse events: a 3-year experience from a tertiary paediatric emergency department. Archives of Disease in Childhood, 109(2), 88-92. |
ISSN | 00039888 |
Abstract | Introduction A well-developed procedural sedation programme in the paediatric emergency department can minimise adverse events. We examined how adherence to current best evidence ensures safe delivery of paediatric sedation in a newly established tertiary paediatric hospital. Methods Our sedation service uses a robust provider training and privileging system, standardised policy and procedures and rigorous data collection all within an evidence-based clinical governance process. We examined sedation data from the first 3 years of operation. Results From July 2018 to May 2022, ketamine was used in 3388 of the 3405 sedations. The mean age of sedated children was 5.5 years (range 6 months to 17.8 years) and common indications were closed reduction of fractures and laceration repairs. A total of 148 (4.37%, 95% CI 3.68% to 5.06%) adverse events were documented, including 88 (2.59%, 95% CI 2.06% to 3.13%) cases of vomiting, 50 (1.48%, 95% CI 1.07% to 1.88%) cases related to airway and breathing with 40 (1.18%, 95% CI 0.82% to 1.54%) cases of oxygen desaturation, 6 (0.18%, 95% CI 0.04% to 0.32%) cases of laryngospasm, 4 (0.12%, 95% CI 0% to 0.23%) cases of apnoea. Conclusion This study presents a large single-centre dataset on the use of intravenous ketamine in paediatric procedural sedation. Adhering to international standards and benchmarks for provider skills and training, drug administration and monitoring facilities, with a strict clinical governance process, optimizes patient safety. |
Language | en |
Publisher | BMJ Publishing Group |
Subject | analgesia emergency care paediatric emergency medicine pain |
Type | Article |
Pagination | 88-92 |
Issue Number | 2 |
Volume Number | 109 |
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