title: Procedural sedation use in the ED: management of pediatric ear and nose foreign bodies.
abstract: This is the first report of which we are aware that describes the use of procedural sedation for the emergency department management of ear and nose foreign bodies in children < 18 years of age. During a 5.5-year period, we identified 312 cases of children with a foreign body in a single orifice (174 ear, 138 nose). Procedural sedation was performed in 23% of cases (43 ear, 28 nose) and ketamine was used most commonly (92%). Emergency physicians had a high rate of success in removing foreign bodies (84% ear, 95% nose) and a low complication rate. Procedural sedation had a positive effect on the success rate as more than half of the sedation cases had undergone failed attempts without sedation by the same physician. Emergency physicians should have familiarity with this indication for procedural sedation.
authors.affiliation: Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, 11234 Anderson Street, Loma Linda, CA 92354, USA. LBrownMD@AOL.com
authors.forename: Lance
authors.initials: L
authors.lastname: Brown
authors.forename: T Kent
authors.initials: TK
authors.lastname: Denmark
authors.forename: William A
authors.initials: WA
authors.lastname: Wittlake
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Vargas
authors.forename: Timothy
authors.initials: T
authors.lastname: Watson
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Crabb
mesh_terms: D000778:Anesthetics, Dissociative; D002675:Child, Preschool; D016292:Procedural Sedation / Q000706:statistics & numerical data; D004423:Ear; D004636:Emergency Service, Hospital; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis*; D006801:Humans; D006993:Hypnotics and Sedatives; D007649:Ketamine; D016015:Logistic Models; D008297:Male; D008874:Midazolam; D009666:Nose; D012189:Retrospective Studies
chemical_list: D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D008874:Midazolam