title: Procedural pediatric sedation by nurses: available, competent, and safe.
abstract: Sedation and/or analgesia are standard of care for pediatric patients during painful intervention or medical imaging requiring immobility. Physician availability is frequently insufficient to allow for all procedural sedation. A nurse-led sedation program was created at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) to address this problem. Objective. To evaluate the effectiveness and the safety of our program. Methods. A retrospective study of all the procedural sedations done over one year was performed. Complications were separated in four categories: (1) major complications (call for help; unexpected admission, aspiration, and code); (2) reportable sedation events (oxygen saturation <90%, bradycardia (more than 2 SD below normal for the age of the child), and hypotension (more than 2 SD below normal for the age of the child); (3) difficult sedation (agitation, inadequate sedation, and failure to perform the procedure), (4) minor complications. Results. 448 patients, 249 boys and 199 girls; received sedation for 555 procedures. Overall, 78% (432) of interventions were successfully accomplished: 0% of major complications, 8% of reportable sedation events; 5% of difficult sedation; 9% of minor complications. Conclusion. Our nurse-led sedation program compares favorably to other similar systems.
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12 Avenue Nord, Sherbrooke, QC, Canada J1H 5N4.
authors.forename: Laetiscia
authors.initials: L
authors.lastname: Lavoie
authors.forename: Catherine
authors.initials: C
authors.lastname: Vezina
authors.forename: Emilie
authors.initials: E
authors.lastname: Paul-Savoie
authors.forename: Claude
authors.initials: C
authors.lastname: Cyr
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lafrenaye