By Leslie Coplin, Executive Editor, AHC Media
(This information first ran as breaking news on July 5 on the website for our publisher, AHC Media. To keep up with breaking news in the healthcare field as it happens, readers can go to reliasmedia.com.)
The American Academy of Pediatrics, with the American Academy of Pediatric Dentistry, has issued updated clinical guidelines for delivering safe sedation to pediatric patients before, during, and after diagnostic and therapeutic procedures.
Over the past 20 years, the number of procedures performed on children in outpatient settings has increased, which has led to the need for increased awareness of the importance of providing safe sedation. The guidelines include two major changes to sedation procedures.
First, children who are deeply or moderately sedated should have capnography monitoring to measure expired carbon dioxide and ensure airway patency and gas exchange. Second, the assistant to the person monitoring sedation is required to have pediatric advanced life support training.
Other key highlights of the guidelines include:
- appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure;
- recovery to the presedation level of consciousness before discharge from medical/dental supervision;
- no administration of sedating medication without the safety net of medical/dental supervision;
- careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications;
- a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase the potential for airway obstruction;
- a clear understanding of the medication’s pharmacokinetic and pharmacodynamic effects and 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 staff to carry out the procedure and monitor the patient;
- appropriate physiologic monitoring during and after the procedure;
- a properly equipped and staffed recovery area;
- appropriate discharge instructions.
(To access the guidelines, readers can go to http://bit.ly/29kkgXj.)