A pediatric sedation/anesthesia program with dedicated care by anesthesiologists and nurses for procedures outside the operating room.
OBJECTIVE
To examine the performance of a pediatric sedation team working according to a specific protocol and to assess parental satisfaction with the service.


METHODS
A descriptive observational study of all procedures performed by the sedation team (comprising sedation-trained pediatric intensive care nurses and dedicated anesthesiologists) in a university hospital over 6 years. Data collected included demographics, procedure and location, sedation staff present, sedation failure, drugs used, requirements for escalation of sedation, complications, and parental satisfaction.


RESULTS
Sedation was provided for 8760 procedures in 5554 children. The sedation nurse started 1769 (20%) procedures using triclofos sodium and required the assistance of the anesthesiologist in 115 (6.5%) cases. The remaining 6991 (80%) cases were performed by the anesthesiologist, predominantly using propofol (in 72.5% of cases). No cases were deferred as a result of insufficient sedation. Adverse events were recorded in 153 (1.7%) children. Of these, 132 (86%) were mild decreases in oxygen saturation. Three children were not discharged as a result of oversedation. Feedback indicated that 95% of parents were very satisfied with the sedation service.


CONCLUSIONS
A dedicated sedation team using a written protocol provides a service with minimal case cancellation, zero sedation failure, very good safety, and excellent parental satisfaction.
Gozal
David
D
Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, Jerusalem, Israel.
Drenger
Benjamin
B
Levin
Phillip D
PD
Kadari
Avishag
A
Gozal
Yaacov
Y
D000293:Adolescent; D000768:Anesthesia, General / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001007:Anxiety / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007557:Israel; D008297:Male; D008991:Monitoring, Physiologic; D024802:Nurse's Role; D010755:Organophosphates / Q000627:therapeutic use; D010100:Oxygen / Q000097:blood; D010290:Parents / Q000523:psychology; D010348:Patient Care Team; D017060:Patient Satisfaction; D018579:Patient Selection; D015397:Program Evaluation; D015742:Propofol / Q000627:therapeutic use; D011446:Prospective Studies
D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010755:Organophosphates; C004345:triclofos; D010100:Oxygen; D015742:Propofol