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Paediatric sedation in emergency department: what is our practice?
Ian Everitt1, Paul Younge, Peter Barnett
1Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia. ianjeveritt@hotmail.com
Objectives:
The aim of the present study was to document the use of sedation in paediatric patients in emergency departments within Australia and New Zealand.
Methods:
A questionnaire was sent to 54 emergency departments throughout Australia and New Zealand.
Results:
A total of 45 departments (83%) responded to the survey. Because the adult departments (n 5) reported few paediatric attendances, they were not included in the analysis. Thirty-nine of 40 departments (97.50%) reported using sedation in children. Midazolam was used most frequently (77%) for sedation. There was marked variation in the route of delivery and the dose of midazolam used. Ketamine was reported as the most efficacious agent used, but it was used only in 12% of cases. Formal guidelines existed in all paediatric departments but only in 58% of mixed departments, and formal discharge criteria were used in only 52% of all departments. The use of topical anaesthesia in wound closure was reported in only 3,000 of departments.
Conclusions:
There exists wide variation in practice regarding the use of sedation in children in emergency departments throughout Australia and New Zealand. Thus, the development of adequate guidelines, including discharge instructions and the use of topical agents, will improve sedation for children.