title: Current practices for paediatric procedural sedation and analgesia in emergency departments: results of a nationwide survey in Korea.
abstract: OBJECTIVE
  Procedural sedation and analgesia (PSA) in children has become a standard tool in emergency settings, but no national PSA guidelines have been developed for the emergency department (ED) in Korea. Therefore, we investigated the practice of PSA and the level of adherence to institutional PSA guidelines in EDs of teaching hospitals.
  
  
  METHODS
  This study was a cross-sectional, web-based survey. The study subjects were the faculty of EDs from 96 teaching hospitals. The questionnaire was posted on an internet site, and the participants were requested that the questionnaire be answered by email and telephone in May 2009.
  
  
  RESULTS
  The questionnaires were completed by 67.7% of the participants. Only 20% of EDs had institutional PSA guidelines, 21.5% of those had discharge criteria and 13.8% of EDs had a discharge instruction form. Residents were administered PSA at 76.9% of EDs. The airway rescue equipment was near the area where PSA was performed in 76.9% of EDs. The most commonly used medication for both diagnostic imaging and painful procedure was oral chloral hydrate (87.7%, 61.5%). In 64.6% of EDs, patients were monitored. In only 21 cases, EDs (50.0%) monitored the patients to recovery after PSA or discharge.
  
  
  CONCLUSIONS
  Current PSA for paediatric patients have not been appropriately applied in Korea. Unified PSA guidelines were rare in the hospitals surveyed, and many patients were not monitored over an appropriate duration, nor did they receive adequate medications for sedation by the best trained personnel. Therefore, the national PSA guidelines must be developed and implemented as early as possible.
authors.affiliation: Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University, Seoul, Republic of Korea.
authors.forename: Jun Seok
authors.initials: JS
authors.lastname: Seo
authors.forename: Do Kyun
authors.initials: DK
authors.lastname: Kim
authors.forename: Youngjoon
authors.initials: Y
authors.lastname: Kang
authors.forename: Yeon Young
authors.initials: YY
authors.lastname: Kyong
authors.forename: Jin Joo
authors.initials: JJ
authors.lastname: Kim
authors.forename: Ji Yun
authors.initials: JY
authors.lastname: Ahn
authors.forename: Ji Sook
authors.initials: JS
authors.lastname: Lee
authors.forename: Hye Young
authors.initials: HY
authors.lastname: Jang
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Jung
authors.forename: Yoon Hee
authors.initials: YH
authors.lastname: Choi
authors.forename: Seung Baik
authors.initials: SB
authors.lastname: Han
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000698:Analgesia / Q000592:standards*; D016009:Chi-Square Distribution; D002648:Child; D016292:Procedural Sedation / Q000592:standards*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000592:standards*; D019983:Guideline Adherence; D006784:Hospitals, Teaching; D006801:Humans; D010372:Pediatrics / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D056910:Republic of Korea; D011795:Surveys and Questionnaires