To the Editor.

The vitriolic comments by Drs Freeman and Vining regarding various sedation/analgesia guidelines and Dr Coté's critical incident analysis of sedation-related adverse events underscore the need for the utilization of evidence in the evaluation of the safety of such practices.^1,2 Drs Freeman and Vining contend that sedation alone for a nonpainful procedure such as an electroencephalogram (EEG) is inherently safe. They therefore suggest that the use of chloral hydrate alone for an EEG does not warrant any monitoring or attendance by qualified medical personnel as mandated by the Joint Commission on Accreditation of Healthcare Organizations and recommended by the American Academy of Pediatrics. Furthermore, they contend that such mandates are unnecessary and fiscally onerous. The evidence does not support their contention. We agree that the majority of children who receive sedation, analgesia, or both for a diagnostic or therapeutic procedure experience good outcomes with no long-term sequelae. However, the fortunately . . . [Full Text of this Article]