Procedural Pediatric Sedation by Nurses : Available, Competent, and Safe

الملخص EN

Sedation and/or analgesia are standard of care for pediatric patients during painful intervention or medical imaging requiring immobility.

Physician availability is frequently insufficient to allow for all procedural sedation.

A nurse-led sedation program was created at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) to address this problem.

Objective.

To evaluate the effectiveness and the safety of our program.

Methods.

A retrospective study of all the procedural sedations done over one year was performed.

Complications were separated in four categories: (1) major complications (call for help; unexpected admission, aspiration, and code); (2) reportable sedation events (oxygen saturation <90%, bradycardia (more than 2 SD below normal for the age of the child), and hypotension (more than 2 SD below normal for the age of the child); (3) difficult sedation (agitation, inadequate sedation, and failure to perform the procedure), (4) minor complications.

Results.

448 patients, 249 boys and 199 girls; received sedation for 555 procedures.

Overall, 78% (432) of interventions were successfully accomplished: 0% of major complications, 8% of reportable sedation events; 5% of difficult sedation; 9% of minor complications.

Conclusion.

Our nurse-led sedation program compares favorably to other similar systems.