[Preparation and monitoring of sedation and analgosedation carried out by pediatricians and pediatric training assistants].
BACKGROUND
Sedation and analgosedation form part of the every-day work in the clinical care of pediatric patients. The American Academy of Pediatrics (AAP), the American Society of Anesthesiologists (ASA) and the German Society for Anesthesiology and Intensive Care (DGAI) have established guidelines outlining the general conditions for sedating/analgosedating measures. Since the provisions of the specialist associations diverge in some respects, we have developed an own standard. This takes into account the existing guidelines, aiming at maximum safety for our patients and maximum practicability.


METHODS
In line with the guidelines of the above specialist societies and the international literature, we have developed a standard referring to the information of patients, eating and drinking, monitoring before, during and after the sedation/analgosedation as well as documentation. Over a 12-month period, this standard was applied to all sedations/analgosedations in our hospital which were not performed by the intensive care department. All measures were recorded in a protocol specifically designed for this purpose.


RESULTS
In the twelve months under review, a total of 103 sedations/analgosedations were performed (39 of which for bone marrow puncture or punch biopsies, 27 for gastroscopies or coloscopies and 24 for arthrocenteses). None of the sedations or analgosedations implied complications endangering any of our patients. The standard applied proved to be practicable. It was only the documentation, which is closely related to anaesthesiologist protocols, which required adjustment from our staff initially.


CONCLUSIONS
The standard we have developed and applied provides a practicable and safe protocol to regulate the preparation and monitoring of sedations and analgosedations for pediatric patients. A specific guideline to be issued by the Deutsche Gesellschaft für Kinder- und Jugendmedizin (German Pediatric Society) is considered desirable.
Sauer
H
H
Klinik für Kinder- und Jugendmedizin am Klinikum Bayreuth. dhsauer@t-online.de
Haase
R
R
Lieser
U
U
Horneff
G
G
D000293:Adolescent; D000295:Adolescent Medicine / Q000193:education*; D019985:Benchmarking; D002648:Child; D016292:Procedural Sedation / Q000592:standards*; D004503:Education, Medical, Graduate / Q000592:standards*; D005858:Germany; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D010372:Pediatrics / Q000193:education*; D017410:Practice Guidelines as Topic; D017751:Safety Management / Q000592:standards; D013038:Specialization