The development of a pediatric radiology sedation program.
BACKGROUND
An increase in the number of patients undergoing sedation for imaging procedures has led to many changes in practice over the past 10 years.


OBJECTIVE
The purpose of this study was to compare and evaluate sedation practice changes in a pediatric radiology department during the last 5 years.


METHODS
The radiology computer database and corresponding minutes of the Radiology Sedation Committee were reviewed to identify changes in sedation policy. Data from three blocks of time were analyzed to determine time to sedation, time to discharge, drug frequency, rates of adverse events, sedation failure, and paradoxical reaction.


RESULTS
Specific practice changes undertaken over the 5-year period include: (1) increased speed of administration of IV pentobarbital, (2) alternating pentobarbital and fentanyl, (3) presedation with midazolam, and (4) administering oral pentobarbital to children under and (5) over 12 months of age. Based on data analysis, changes 1 and 4 were incorporated into the sedation policy, while changes 2, 3, and 5 were abandoned. Comparison of data from the three time segments revealed improvement in the time to sedation, sedation failure, adverse event, and paradoxical reaction rates.


CONCLUSIONS
There is improvement in all aspects of patient outcomes with sedation, as a result of several changes in sedation practice.
Karian
Victoria E
VE
Department of Radiology, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. victoria.karian@tch.harvard.edu
Burrows
Patricia E
PE
Zurakowski
David
D
Connor
Linda
L
Poznauskis
Linda
L
Mason
Keira Park
KP
D016292:Procedural Sedation / Q000592:standards / Q000639:trends*; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000592:standards; D007223:Infant; D007229:Infant Welfare; D008279:Magnetic Resonance Imaging / Q000592:standards / Q000639:trends; D010372:Pediatrics / Q000592:standards / Q000639:trends*; D017410:Practice Guidelines as Topic; D015397:Program Evaluation / Q000592:standards / Q000639:trends*; D015642:Radiology, Interventional / Q000592:standards / Q000639:trends*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000592:standards / Q000639:trends; D016896:Treatment Outcome; D014481:United States
D006993:Hypnotics and Sedatives