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An interprofessional pediatric procedural sedation service: development, pilot testing, and implementation.

Mark W Crawford1, Tobias Everett2, Sheelagh Kemp2

  • 1Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. mark.crawford@sickkids.ca.

Journal of Anesthesia
|November 15, 2025
PubMed
Summary
This summary is machine-generated.

A new standardized procedural sedation service significantly improved pediatric patient care. This interprofessional model enhanced sedation quality and outcomes in both outpatient and inpatient settings.

Keywords:
Anesthesia assistantInterprofessional care teamPediatric anesthesiaProcedural sedation

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Area of Science:

  • Pediatric Anesthesiology
  • Healthcare Quality Improvement
  • Sedation Management

Background:

  • Standardized procedural sedation is crucial for safe, effective pediatric care.
  • Tertiary pediatric hospitals require optimized sedation services for diverse patient populations.
  • Existing sedation practices may lack standardization, impacting patient outcomes.

Purpose of the Study:

  • To develop and implement a standardized interprofessional procedural sedation service at a tertiary pediatric hospital.
  • To improve the safety, effectiveness, and timeliness of pediatric sedation.
  • To evaluate the impact of a standardized sedation service on patient outcomes.

Main Methods:

  • A working group developed the sedation model, incorporating literature review, benchmarking, and environmental scans.
  • Sedation outcomes were assessed using the Dartmouth Operative Conditions Scale (DOCS) and Ramsay Sedation Score (RSS).
  • Two pediatric groups were studied: dental outpatients and inpatients undergoing chest tube removal; pre- and post-implementation data were compared.

Main Results:

  • The standardized service significantly improved optimal sedation rates. For dental patients, optimal DOCS scores increased from 32% to 94% during local anesthetic injection and 18% to 94% during tooth extraction.
  • In chest tube removal patients, optimal DOCS scores rose from 22% to 100%, with a significant improvement in Ramsay scores from a median of 1 to 4.
  • The interprofessional model demonstrated substantial improvements in sedation quality and patient outcomes across different pediatric settings.

Conclusions:

  • Implementation of a standardized, interprofessional sedation service aligned with best practices enhances pediatric sedation quality.
  • The new service model led to significant improvements in patient outcomes for both outpatient and inpatient procedures.
  • Standardized sedation protocols are essential for optimizing care in tertiary pediatric hospitals.