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The development of a Consensus Conference on Pediatric Procedural Sedation in the Emergency Department in Italy: from
Idanna Sforzi1, Silvia Bressan2, Claudia Saffirio3
1Pediatric Emergency Department and Trauma Center, Meyer Children's Hospital, Viale Pieraccini 24, 50139, Florence, Italy. idanna.sforzi@meyer.it.
Insights
This consensus conference established 86 recommendations for safe pediatric procedural sedation and analgesia (PSA) in Italian Emergency Departments (EDs). These guidelines aim to standardize care for children undergoing painful procedures, addressing a gap in recognized pediatric emergency medicine standards.
Area of Science:
- Pediatric Emergency Medicine
- Procedural Sedation and Analgesia (PSA)
Background:
- Pediatric Emergency Medicine lacks formal subspecialty recognition in Italy, leading to inconsistent standards of care.
- Procedural Sedation and Analgesia (PSA) in Emergency Departments (EDs) is often neglected or inconsistently applied.
- A need exists for standardized, evidence-based guidelines for pediatric PSA in Italian EDs.
Framework:
- The first multidisciplinary and multi-professional Consensus Conference on pediatric PSA in Italy was convened in 2017.
- The conference followed recommended National methodological standards for preparation, organization, and conduct.
- Professionals from diverse specialties nationwide were invited to participate.
Implementation:
- Developed 86 recommendations across 8 key themes relevant to pediatric PSA.
- Themes included pre-sedation evaluation, pharmacologic agents, monitoring, and equipment.
- Considered Italian healthcare organization and training system characteristics.
Implications:
- Provides national guidance to enhance the standard of care for children in EDs.
- Aims to improve the safety and effectiveness of procedural sedation and analgesia.
- Recommendations will be periodically updated based on new evidence.
Background:
In Italy, as in many European countries, Pediatric Emergency Medicine is not formally recognized as a pediatric subspecialty, hindering nation-wide adoption of standards of care, especially in the field of procedural sedation and analgesia (PSA) in the Emergency Department (ED). For this reason PSA in Italy is mostly neglected or performed very heterogeneously and by different providers, with no reference standard. We aimed to describe the procedures and results of the first multidisciplinary and multi-professional Consensus Conference in Italy on safe and effective pediatric PSA in Italian EDs.
Methods:
The preparation, organization and conduct of the Consensus Conference, held in Florence in 2017, followed the recommended National methodological standards. Professionals from different specialties across the country were invited to participate.
Results:
Overall 86 recommendations covering 8 themes (pre-sedation evaluation, pharmacologic agents, monitoring, equipment and discharge checklists, training, non-pharmacologic techniques, the adult ED setting, impact on hospitalizations) were developed, taking into account the Italian training system and healthcare organization characteristics.
Conclusion:
The results of the first multidisciplinary and multi-professional Consensus Conference in Italy are meant to provide up-to-date national guidance to improve the standard of care of children undergoing painful and stressful procedures in the ED. The recommendations will be periodically updated as new relevant evidence is published.
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