Related Experiment Video

Updated: Jul 6, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Using Quality Improvement Methodology to Inform Safe Implementation of Propofol Procedural Sedation in a Pediatric

Alexandria Wiersma1, Nikita Habermehl, Rebecca Helmuth

  • 1Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.

Pediatric Emergency Care
|July 4, 2026
PubMed

Insights

Quality improvement methodology safely introduced propofol for pediatric procedural sedation in emergency departments. Propofol use reduced sedation and length of stay for selected patients, with low serious adverse events.

Area of Science:

  • Pediatric Emergency Medicine
  • Quality Improvement Science
  • Pharmacology

Background:

  • Procedural sedation in pediatric emergency departments (EDs) is common.
  • Optimizing sedation practices is crucial for patient flow and safety.
  • Propofol offers potential benefits but requires careful implementation.

Purpose of the Study:

  • To implement propofol for pediatric procedural sedation across a multisite ED system using quality improvement (QI) methods.
  • To evaluate the impact of propofol on sedation duration, length of stay (LOS), and serious adverse events (SAEs).

Main Methods:

  • A QI initiative employed the Define-Measure-Analyze-Improve-Control (DMAIC) framework across 4 pediatric EDs.
  • A standardized propofol sedation protocol was developed and implemented for short procedures in low-risk patients.
  • Interventions included protocol development, multidisciplinary education, simulation, and EMR order set modifications.

Main Results:

  • Propofol sedation was significantly shorter than ketamine sedation (18-24 min vs. 33-52 min; P < 0.001).
  • ED LOS was shorter for propofol sedations at primary and secondary sites.
  • Serious adverse event (SAE) rates remained low and stable (2.6% for propofol-associated SAEs).

Conclusions:

  • QI methodology facilitated the safe and feasible implementation of propofol in a multisite pediatric ED system.
  • Propofol use, within a defined scope, shortened sedation length and LOS for selected pediatric patients.
  • This study provides a reproducible framework for implementing propofol sedation in similar settings.
Abstract

Keywords:
deep sedationfeasibilityimplementationprocedural sedationsafety

More Related Videos

Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs08:58

Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs

Published on: October 31, 2025

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Drug Delivery: Enteral Route01:18

Drug Delivery: Enteral Route

The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
Drugs in...
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...