Professional skills and competence for safe and effective procedural sedation in children: recommendations based on a systematic review of the literature.

International Journal of Pediatrics
Piet L J M LeroyHans J T A Knape

Abstract

Objectives. To investigate which skills and competence are imperative to assure optimal effectiveness and safety of procedural sedation (PS) in children and to analyze the underlying levels of evidence. Study Design and methods. Systematic review of literature published between 1993 and March 2009. Selected papers were classified according to their methodological quality and summarized in evidence-based conclusions. Next, conclusions were used to formulate recommendations. Results. Although the safety profiles vary among PS drugs, the possibility of potentially serious adverse events and the predictability of depth and duration of sedation define the imperative skills and competence necessary for a timely recognition and appropriate management. The level of effectiveness is mainly determined by the ability to apply titratable PS, including deep sedation using short-acting anesthetics for invasive procedures and nitrous oxide for minor painful procedures, and the implementation of non-pharmacological techniques. Conclusions. PS related safety and effectiveness are determined by the circumstances and professional skills rather than by specific pharmacologic characteristics. Evidence based recommendations regarding necessary skill...Continue Reading

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Citations

Sep 13, 2015·Paediatric Respiratory Reviews·Jane S LucasEric Haarman
Nov 2, 2011·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Michael TurmelleDouglas W Carlson
Feb 10, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Lisa HartlingLisa Evered
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Jan 4, 2019·Pediatric Blood & Cancer·Karolina MaslakAndrea Di Cataldo
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Jun 19, 2015·Current Opinion in Anaesthesiology·Esther R Michel Foehn
Apr 16, 2018·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Heather A MartinNicholas Wodo

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Methods Mentioned

BETA
sedation
sedations
biopsies
bone marrow aspiration
medical

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