title: New routes in pediatric sedation: a research-based protocol for intranasal midazolam.
abstract: The quality assurance and improvement committee on a general pediatric unit identified a problem with sedation for neuroradiologic studies. Twenty-three percent of children (n = 63) failed to sedate with one dose of chloral hydrate, resulting in delays or cancellations. For children receiving a second dose of chloral hydrate, average time to study completion was 97 minutes, and 70 percent of the children (n = 10) were successfully sedated. A protocol was developed for the use of intranasal midazolam as the follow-up agent. Evaluation on a pilot unit revealed that the average time to test completion decreased to 55 minutes and that the success rate was 82 percent (n = 11). The nursing staff prefer the use of intranasal midazolam as the follow-up agent because of its quicker sedation and decreased duration of action.
authors.affiliation: Pediatric Nursing Division, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors.forename: E R
authors.initials: ER
authors.lastname: Weber
authors.forename: D
authors.initials: D
authors.lastname: Holida
authors.forename: M A
authors.initials: MA
authors.lastname: Moore
authors.forename: G K
authors.initials: GK
authors.lastname: Burdreau
mesh_terms: D000281:Administration, Intranasal; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000627:therapeutic use*; D016292:Procedural Sedation; D004359:Drug Therapy, Combination; D006760:Hospitalization; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008874:Midazolam / Q000008:administration & dosage*; D009732:Nursing Care; D010865:Pilot Projects; D011787:Quality of Health Care; D014057:Tomography, X-Ray Computed
chemical_list: D006993:Hypnotics and Sedatives; D002697:Chloral Hydrate; D008874:Midazolam