Sedation practices for Australian and New Zealand paediatric oncology patients.
OBJECTIVE
Paediatric oncology patients often require repeated bone marrow aspirates and lumbar punctures. These procedures commonly require sedation and analgesia. The Australian and New Zealand College of Anaesthetists and the American Academy of Pediatrics have published guidelines that provide recommendations on monitoring and staffing requirements during sedation of paediatric patients. A survey was conducted of the oncology units in Australia and New Zealand in order to compare current practices with published guidelines.


METHODS
Telephone interviews were conducted with nursing or medical staff members.


RESULTS
Fourteen oncology units collectively perform approximately 130 procedures each week, of which 74% are performed under general anaesthesia. Of the remainder, most are performed using conscious sedation. Most units adhere to published recommendations regarding equipment and staffing during procedures performed under sedation. Only a minority of units follow guidelines regarding documentation; fasting requirements; observation and documentation of vital signs during and after the procedure; and obtaining informed consent for procedures performed using sedation.


CONCLUSIONS
Sedation practices among paediatric oncology units in Australia and New Zealand vary. None of the units fully adhere to published guidelines on childhood sedation. Paediatric oncology units should be familiar with the content of these guidelines and make an informed decision as to their usefulness, both in directing best clinical practice, and in supporting current practice in the event of medico-legal challenge.
Barnes
C
C
Department of Haematology and Oncology, Royal Children's Hospital, Melbourne, Victoria, Australia.
Downie
P
P
Chalkiadis
G
G
Camilleri
S
S
Monagle
P
P
Waters
K
K
D000700:Analgesics / Q000008:administration & dosage*; D001315:Australia; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D002648:Child; D016292:Procedural Sedation / Q000592:standards* / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D009369:Neoplasms / Q000473:pathology / Q000628:therapy*; D009520:New Zealand; D016522:Oncology Service, Hospital / Q000592:standards*; D010372:Pediatrics / Q000592:standards*; D017410:Practice Guidelines as Topic; D013129:Spinal Puncture; D011795:Surveys and Questionnaires
D000700:Analgesics