PEDIATRICS Vol. 118 No. 6 December 2006, pp. 2587-2602 (doi:10.1542/peds.2006-2780)
CLINICAL REPORT |
Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An Update
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 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. This report was developed through a collaborative effort of the American Academy of Pediatrics and the American Academy of Pediatric Dentistry to offer pediatric providers updated information and guidance in delivering safe sedation to children.
Key Words: sedation • guidelines • procedures • adverse events • outcomes • accidents • prevention • monitoring • drug interactions • pediatric • children
Abbreviations: AAP—American Academy of Pediatrics • AAPD—American Academy of Pediatric Dentistry • ASA—American Society of Anesthesiologists • EMS—emergency medical services • ECG—electrocardiography • LMA—laryngeal mask airway
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The following policy statements have been revised:
- Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: Addendum
Pediatrics 110: 836-838.[Full Text]
- Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation For Diagnostic and Therapeutic Procedures
Pediatrics 89: 1110-1115.
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