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[Preparation of sedation-analgesia procedures in spanish paediatric emergency departments: A descriptive study]
Concepción Míguez Navarro1, Niki Oikonomopoulou1, Jorge Lorente Romero1
1Servicio de Urgencias Pediátricas, Hospital General Universitario Gregorio Marañón, Madrid, España.
Insights
This study analyzed sedation-analgesia (SA) practices in Spanish pediatric emergency centers, finding most procedures were prepared correctly according to guidelines. Key findings include common drug combinations and monitoring techniques used for pediatric SA.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Practice Guidelines
- Patient Safety
Background:
- Sedation-analgesia (SA) is crucial in pediatric emergency care.
- Standardized preparation and execution of SA procedures are vital for patient safety.
- Current practices in Spain needed evaluation.
Purpose of the Study:
- To describe current practices for sedation-analgesia (SA) procedures in Spanish pediatric emergency centers.
- To assess adherence to established guidelines for SA in children.
- To identify common methodologies and challenges in pediatric SA.
Main Methods:
- A multicenter, observational, prospective analytical study.
- Data collected from 18 Spanish pediatric emergency departments (February 2015 - January 2016).
- Included 658 SA procedures in children under 18 years.
Main Results:
- Most SA procedures (658 total) were for painful or very painful procedures.
- Informed consent was obtained in 98.6% of cases, with written consent more frequent for severe pain.
- Paediatricians and residents most commonly administered SA, with trauma and surgical reasons being primary indications. Monitoring via pulse oximetry was frequent (67.3%).
- Common pharmacological strategies included single-drug administration (e.g., nitrous oxide) or combinations (e.g., midazolam/ketamine).
Conclusions:
- The majority of analyzed SA procedures were performed correctly.
- Preparation and execution generally aligned with current clinical guidelines.
- The study highlights adherence to best practices in pediatric SA in Spain.
Introduction:
The objective of this study was to describe the current practice regarding the preparation of the sedation-analgesia (SA) procedures performed in the paediatric emergency centres in Spain.
Material And Methods:
A multicentre, observational and prospective analytical study was carried out on the SA procedures that were performed on children under 18 years-old in 18 paediatric emergency departments between February 2015 and January 2016.
Results:
A total of 658 SA procedures were registered in 18 hospitals of Spain, most of them to children older than 24 months. The type of the procedure was: simple analgesia in 57 (8.6%), sedation in 44 (6.7%), SA for a not very painful procedure in 275 (41.8%), and SA for a very painful procedure in 282 (42.9%). Informed consent was requested in 98.6% of the cases. The written form was more frequently preferred in the group of patients that received SA for a very painful procedure (76.6%) in comparison to a painful procedure or to simple analgesia (62.9% and 54.4%, respectively, P<.001). The staff that most frequently performed the SA procedures were the paediatricians of the emergency departments (64.3%), followed by Paediatrics Residents (30.7%). The most frequent reasons for the SA were traumatological (35.9%) and surgical (28.4%). Fasting was observed in 81% of the cases. More than two-thirds (67.3%, n=480) children were monitored, the majority (95.8%) of them using pulse oximetry. The pharmacological strategy used was the administration of one drug in 443 (67.3%) of the cases, mostly nitrous oxide, and a combination of drugs in 215 (32.7%), especially midazolam/ketamine (46.9%).
Conclusion:
The majority of the SA procedures analysed in this study have been carried out correctly and prepared in accordance with the current guidelines.
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