Creation and Implementation of a Hospitalist-Run Propofol Sedation Program

Area of Science:

• Pediatric hospital medicine
• Sedation and analgesia
• Medical education and training

Background:

• Pediatric hospitalists are increasingly involved in procedural sedation outside the operating room.
• Propofol is a safe and effective agent for deep sedation, supported by extensive safety data.
• Current training for hospitalist-provided sedation varies significantly between institutions.

Purpose of the Study:

• To develop and implement a standardized training program for pediatric hospitalists in the use of propofol for deep sedation.
• To evaluate the safety and efficacy of propofol-based deep sedation administered by trained hospitalists for MRI procedures.

Main Methods:

• A task force developed and implemented a comprehensive training curriculum for hospitalists administering propofol.
• Patient outcomes, including adverse event rates and procedure completion rates, were analyzed retrospectively.
• Adverse events were defined by specific clinical criteria, and successful completion was defined as completing the imaging study or procedure.

Main Results:

• Over a three-year period, 3,929 pediatric patients received deep sedation with propofol administered by trained hospitalists.
• The adverse event rate was 3.6%, with no major complications reported.
• The successful completion rate for imaging studies and procedures was 98.9%.

Conclusions:

• A comprehensive training program enables pediatric hospitalists to safely and effectively administer propofol for deep sedation.
• This standardized approach facilitates the training of new faculty, ensuring consistent, high-quality sedation services.
• Hospitalist-led propofol sedation is a viable option for select pediatric patients undergoing procedures outside the OR.