Procedural sedation programme minimising adverse events: a 3-year experience from a tertiary paediatric emergency department

Erumbala, Gokul, Anzar, Sabu, Deiratany, Samir, Blackie, Barbara, Powell, Colin and Al Ansari, Khalid 2024. Procedural sedation programme minimising adverse events: a 3-year experience from a tertiary paediatric emergency department. Archives of Disease in Childhood 109 , pp. 88-92. 10.1136/archdischild-2023-326021

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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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	BMJ Publishing Group
ISSN:	0003-9888
Date of First Compliant Deposit:	9 October 2023
Date of Acceptance:	12 September 2023
Last Modified:	20 Feb 2024 15:04
URI:	https://orca.cardiff.ac.uk/id/eprint/163059

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