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Pediatric Sedation: Using Secondary Data to Describe Registered Nurse Practice in Radiology
1Georgetown University.
Insights
Registered nurses safely monitored pediatric sedation for diagnostic radiology, with a 5.78% adverse event rate. Common events included agitation and desaturation, but serious complications were absent.
Area of Science:
- Pediatric Sedation
- Nursing Practice
- Diagnostic Radiology
Background:
- Children often require sedation for procedures due to developmental and positioning challenges.
- Limited studies describe nurse-led sedation practices and adverse events in pediatrics.
- Existing pediatric sedation studies have small sample sizes, hindering adverse event detection.
Purpose of the Study:
- To report on the practices and outcomes of sedation administered by registered nurses (RNs) to pediatric patients.
- To analyze adverse events in a large cohort of children undergoing diagnostic radiology procedures under nurse-led sedation.
Main Methods:
- Analysis of 12,584 cases from the Pediatric Sedation Research Consortium (PSRC) database.
- Focus on sedation administered by RNs to children aged 0-14 years during diagnostic radiology.
- Monitoring of sedation practices and adverse events.
Main Results:
- A total of 727 adverse events (5.78%) were reported.
- The most common adverse events were inadequate sedation/agitation/delirium (155.8/10,000) and desaturation (138/10,000).
- No deaths, cardiac arrests, intubations, or aspirations occurred in this cohort.
Conclusions:
- Nurse-monitored sedation for pediatric diagnostic radiology appears safe, with a low incidence of severe adverse events.
- Further research comparing sedation practices across different provider types is necessary.
- Findings support the role of RNs in pediatric procedural sedation, highlighting areas for practice improvement.
Abstract:
Children, often require sedation for procedures due to their developmental level and difficulty complying with positioning. There are few studies that describe nurse sedation practices or adverse events. Studies of pediatric sedation care have small sample sizes that are inadequate to detect adverse events. This study reports practices and outcomes of sedation delivered to children from infancy up to 14 years of age, that were monitored only by registered nurses (RNs) during diagnostic radiology procedures drawn from a sample of 12,584 cases from the Pediatric Sedation Research Consortium (PSRC) database. There were 727 adverse events (5.78%). However, no deaths, cardiac arrests, intubations or aspirations were reported in this sample. The most common adverse event was inadequate sedation/agitation/delirium 196 (155.8/10,000) and desaturation below baseline for greater than 30 seconds 173 (138/10,000). Further research comparing sedation practices and outcomes by type of providers, including nurses, are necessary to improve practice.
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