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Pediatric Procedural Sedation in the Community Emergency Department: results from the ProSCED registry

Alfred Sacchetti1, Eric Stander, Nancy Ferguson

  • 1Department of Emergency Medicine, Our Lady of Lourdes Medical Center, Camden, NJ 08103, USA. a.sacchetti@worldnet.att.net

Pediatric Emergency Care
|April 18, 2007
PubMed

Insights

Community emergency physicians safely provide procedural sedation for pediatric patients, utilizing diverse medications for common procedures like laceration repair and fracture care with high success rates.

Area of Science:

  • Emergency Medicine
  • Pediatric Sedation
  • Procedural Sedation

Background:

  • Pediatric procedural sedation data primarily exists for tertiary care centers.
  • Practices of community hospital-based emergency physicians (EPs) for pediatric sedation are less understood.

Purpose of the Study:

  • To describe the practice patterns and outcomes of procedural sedation for pediatric patients by community EPs.
  • To assess the safety and efficacy of sedation administered by EPs in community hospitals.

Main Methods:

  • Prospective observational study using the "Procedural Sedation in the Community Emergency Department" registry.
  • Data collected on consecutive EP-directed procedural sedation cases in community hospitals.

Main Results:

  • 1028 total sedations, with 341 in patients under 21 years.
  • Common pediatric procedures: laceration repair (25%), shoulder relocation (23%), upper extremity fracture care (16%).
  • Medications included ketamine (41%), midazolam (32%), etomidate (16%), fentanyl (15%), and propofol (14%); 0.6% complication rate.

Conclusions:

  • Community EPs safely and effectively administer pediatric procedural sedation.
  • A wide range of sedative agents are utilized by EPs in community settings.
  • High success rate (99.4%) for attempted procedures.
Abstract

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