Paediatric sedation in emergency department: what is our practice?
OBJECTIVE
The aim of the present study was to document the use of sedation in paediatric patients in emergency departments within Australia and New Zealand.


METHODS
A questionnaire was sent to 54 emergency departments throughout Australia and New Zealand.


RESULTS
A total of 45 departments (83%) responded to the survey. Because the adult departments (n 5) reported few paediatric attendances, they were not included in the analysis. Thirty-nine of 40 departments (97.50%) reported using sedation in children. Midazolam was used most frequently (77%) for sedation. There was marked variation in the route of delivery and the dose of midazolam used. Ketamine was reported as the most efficacious agent used, but it was used only in 12% of cases. Formal guidelines existed in all paediatric departments but only in 58% of mixed departments, and formal discharge criteria were used in only 52% of all departments. The use of topical anaesthesia in wound closure was reported in only 3,000 of departments.


CONCLUSIONS
There exists wide variation in practice regarding the use of sedation in children in emergency departments throughout Australia and New Zealand. Thus, the development of adequate guidelines, including discharge instructions and the use of topical agents, will improve sedation for children.
Everitt
Ian
I
Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia. ianjeveritt@hotmail.com
Younge
Paul
P
Barnett
Peter
P
D001315:Australia; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D009520:New Zealand; D009609:Nitrous Oxide / Q000008:administration & dosage; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D007649:Ketamine; D009609:Nitrous Oxide; D008874:Midazolam