Guideline for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures.
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large tonsils or anatomic airway abnormalities that might increase the potential for airway obstruction, a clear understanding of the pharmacokinetic and pharmacodynamic effects of the medications used for sedation as well as an appreciation for drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of people to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to presedation level of consciousness before discharge from medical supervision, and appropriate discharge instructions.
D000293:Adolescent; D000766:Anesthesia, Dental / Q000145:classification / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods* / Q000592:standards; D054810:Deep Sedation / Q000379:methods / Q000592:standards; D019140:Dental Care for Children / Q000379:methods* / Q000592:standards; D003730:Dental Care for Persons with Disabilities / Q000379:methods / Q000592:standards; D019937:Diagnostic Techniques and Procedures; D006291:Health Policy; D006801:Humans; D007223:Infant; D016343:Monitoring, Intraoperative / Q000379:methods / Q000592:standards*; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards; D009909:Oral Health / Q000592:standards; D010377:Pediatric Dentistry / Q000379:methods* / Q000592:standards; D012953:Societies, Dental / Q000592:standards; D013514:Surgical Procedures, Operative; D014481:United States