Variation in Procedural Sedation Practices Among Children's Hospitals

Area of Science:

• Pediatric hospital medicine
• Sedation practices
• Healthcare resource utilization

Background:

• Procedural sedation is crucial for painful procedures in children.
• Limited data exist on sedation provider, setting, and agents nationwide.
• Practices outside the pediatric intensive care unit (PICU) and emergency department (ED) are understudied.

Purpose of the Study:

• To investigate procedural sedation practices for hospitalized children outside the PICU and ED.
• To identify variations in provider, setting, and agents used for pediatric procedural sedation.
• To assess the impact of pediatric hospitalist involvement on sedation practices and resource use.

Main Methods:

• Surveys were distributed to pediatric hospitalist leaders in major children's hospitals.
• Data were collected on sedation providers, settings, and agents used for various procedures.
• Response rates and completion rates of the surveys were analyzed.

Main Results:

• Pediatric hospitalists provided sedation in 18 of the surveyed hospitals.
• Anesthesiologists were the primary providers for many procedures, including abscess incision and drainage, renal biopsy, and imaging.
• Hospitals with pediatric hospitalist-provided sedation used the operating room less frequently and performed fewer procedures without sedation.

Conclusions:

• Significant variability exists in national procedural sedation practices for hospitalized children.
• Pediatric hospitalist involvement in procedural sedation is associated with decreased operating room utilization.
• Optimizing sedation practices can improve patient care and resource management.