Variations in sedating uncooperative, stable children for post-traumatic head CT.
OBJECTIVE
To characterize variations among pediatric emergency physicians and their hospital facilities regarding sedation of the uncooperative, stable child for head CT following closed head injury.


METHODS
Mail survey with two follow-up mailings.


METHODS
Surveys were sent to all members of the Emergency Medicine Section of the American Academy of Pediatrics (AAP).


RESULTS
Of 596 surveys sent, 431 (72%) were returned, with 304 (51%) usable responses. Respondents annually sedate over 17,500 children for post-traumatic head CT. Formal training to sedate children for head CT was noted by 73%. Published guidelines for sedation are followed by 74%; 10% were unaware of the existence of published guidelines for sedation. Twenty-six percent of the respondents were very or somewhat dissatisfied with their sedation-related practices. In response to three clinical scenarios involving sedation of 8-month-old, 3-year-old, and 6-year-old children for head CT, midazolam was the most commonly chosen drug. Over 20 different sedation strategies were selected for each scenario.


CONCLUSIONS
Sedation practices for post-traumatic pediatric head CT vary widely, among both physicians and individual practitioners. Institutional and individual sedation-relation policies vary widely as well. Variation and dissatisfaction with sedation practices may reflect uncertainty regarding optimal sedation strategies. Further cost-effectiveness research is necessary.
Conners
G P
GP
Department of Emergency Medicine, University of Rochester Medical Center, New York 14642, USA.
Sacks
W K
WK
Leahey
N F
NF
D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003625:Data Collection; D004363:Drug Utilization; D004635:Emergency Medicine / Q000592:standards; D019983:Guideline Adherence; D016489:Head Injuries, Closed / Q000000981:diagnostic imaging* / Q000523:psychology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D014057:Tomography, X-Ray Computed / Q000523:psychology; D014481:United States
D006993:Hypnotics and Sedatives