New routes in pediatric sedation: a research-based protocol for intranasal midazolam.
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.
Weber
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Pediatric Nursing Division, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Holida
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D
Moore
M A
MA
Burdreau
G K
GK
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
D006993:Hypnotics and Sedatives; D002697:Chloral Hydrate; D008874:Midazolam