University of Oulu

Tervonen, M, Kallio, M, Peltoniemi, O. National survey revealed variable practices in paediatric procedural sedation and patient monitoring. Acta Anaesthesiol Scand. 2021; 65: 747– 754. https://doi.org/10.1111/aas.13799

National survey revealed variable practices in paediatric procedural sedation and patient monitoring

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Author: Tervonen, Miikka1,2; Kallio, Merja1,2; Peltoniemi, Outi1,2
Organizations: 1Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
2PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2021070541131
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-07-05
Description:

Abstract

Paediatric procedures requiring sedation are increasingly being performed off site, but there are no national guidelines for paediatric procedural sedation in Finland or studies on it. Therefore, the aim of this survey was to assess national practices for paediatric procedural sedation outside operation rooms and intensive care units in terms of indications, sedative medication, treatment facilities, patient safety and training of the personnel.

An online survey including single- and multiple-choice questions and open-ended questions was sent to Finnish paediatricians, paediatric surgeons and paediatric anaesthesiologists via the electronic mailing lists of national societies in December 2019.

A total of 71 responses were received. Lumbar puncture (41%), intra-articular injections (38%) and MRI (17%) were the most common procedures that required routine sedation. Benzodiazepines were the most frequently used sedatives during both painful procedures (80%) and imaging (61%). Pulse oximetry monitoring was reported by 75% of the respondents, but other physiological parameters were rarely monitored (ECG 28%; blood pressure 39%; respiratory rate 34%). The level of sedation was not objectively assessed. Adrenaline (72%) and equipment for managing adverse respiratory outcomes (supplemental oxygen 98%; ventilation equipment 92%) were available in most facilities in which sedation was performed. Only one-third of the respondents had undergone training for paediatric procedural sedation, and only 39% of the hospital units compiled statistical data on sedation-related adverse events.

The paediatric procedural sedation practices vary across hospitals. National guidelines for patient monitoring and training of personnel could improve treatment quality and patient safety.

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Series: Acta anaesthesiologica Scandinavica
ISSN: 0001-5172
ISSN-E: 1399-6576
ISSN-L: 0001-5172
Volume: 65
Issue: 6
Pages: 747 - 754
DOI: 10.1111/aas.13799
OADOI: https://oadoi.org/10.1111/aas.13799
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Funding: Finnish Foundation for Pediatric Research; Alma and KA Snellman Foundation.
Copyright information: © 2021 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
  https://creativecommons.org/licenses/by-nc-nd/4.0/