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Safer Pediatric Sedations: Simulation Checklists to Improve Knowledge, Attitudes, and Skills in Emergency Medicine
Lawrence Lau1, Ronald V Hall2, Dimitrios Papanagnou2
1Emergency Medicine, Kaiser Permanente Medical Group, San Leandro, USA.
Abstract:
Background Pediatric sedation is a low-frequency, high-stakes procedure. This study aimed to train emergency medicine (EM) residents in pediatric procedural sedation through a sedation checklist, enhancing patient safety. Methods EM residents completed a pre-test and a survey on their knowledge and experiences with sedation protocols. Residents were subdivided into four groups: two control groups underwent a pediatric sedation simulation without the aid of a procedural checklist, while two intervention groups were given the procedural checklist to guide their management of the procedure. Following the simulations, a simulation faculty member reviewed sedation management and safety with residents for all groups and answered questions. An improvement analysis was performed via a post-intervention examination among all residents. Results Residents in the intervention group demonstrated an improvement in obtaining more critical actions during the simulation (intervention group critical actions 14, 13 vs non-intervention critical actions 10, 12) and confidence with the procedure (via a Likert scale survey across multiple arenas of pediatric sedation), with only moderately increased scores on the post-test examination (pre-simulation score of 6.28±2.14; post-simulation score of 6.75±1.88). Conclusion The data suggest that a checklist, combined with dedicated training through simulation, improves knowledge, confidence, and skill with regard to pediatric sedations. Further study is required to examine the longitudinal impact of our program on resident performance and patient outcomes.
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