PMID- 24421451
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140114
LR  - 20220908
IS  - 0018-5787 (Print)
IS  - 1945-1253 (Electronic)
IS  - 0018-5787 (Linking)
VI  - 48
IP  - 2
DP  - 2013 Feb
TI  - Adverse events associated with procedural sedation in pediatric patients in the 
      emergency department.
PG  - 134-42
AB  - PURPOSE: To determine the agents used by emergency medicine (EM) physicians in 
      pediatric procedural sedation and the associated adverse events (AEs) and to 
      provide recommendations for optimizing drug therapy in pediatric patients. 
      METHODS: We conducted a prospective study at Stanford Hospital's pediatric 
      emergency department (ED) from April 2007 to April 2008 to determine the 
      medications most frequently used in pediatric procedural sedation as well as 
      their effectiveness and AEs. Patients, 18 years old or younger, who required 
      procedural sedation in the pediatric ED were eligible for the study. The data 
      collected included medical record number, sex, age, height, weight, procedure 
      type and length, physician, and agents used. For each agent, the dose, route, 
      time from administration to onset of sedation, duration of sedation, AEs, and 
      sedation score were recorded. Use of supplemental oxygen and interventions during 
      procedural sedation were also recorded. RESULTS: We found that in a convenience 
      sample of 196 children (202 procedures) receiving procedural sedation in a 
      university-based ED, 8 different medications were used (ketamine, etomidate, 
      fentanyl, hydromorphone, methohexital, midazolam, pentobarbital, and thiopental). 
      Ketamine was the most frequently used medication (88%), regardless of the 
      procedure. Only twice in the study was the medication that was initially used for 
      procedural sedation changed completely. Fracture reduction was the most 
      frequently performed procedure (41%), followed by laceration/suture repair (32%). 
      There were no serious AEs reported. CONCLUSION: EM-trained physicians can safely 
      perform pediatric procedural sedation in the ED. In the pediatric ED, the most 
      common procedure requiring conscious sedation is fracture reduction, with 
      ketamine as the preferred agent.
FAU - Cudny, Magdalena E
AU  - Cudny ME
AD  - Clinical Pharmacist, Department of Pharmacy, Stanford Hospital and Clinics, 
      Stanford, California.
FAU - Wang, N Ewen
AU  - Wang NE
AD  - Associate Professor, Department of Surgery, Division of Emergency Medicine, 
      Stanford University School of Medicine, and Associate Director of Pediatric 
      Emergency Medicine, Stanford Hospital and Clinics, Stanford, California.
FAU - Bardas, Sandra L
AU  - Bardas SL
AD  - Clinical Pharmacist, Emergency Medicine, Stanford Hospital and Clinics, Stanford, 
      California.
FAU - Nguyen, Carolyn N
AU  - Nguyen CN
AD  - Clinical Pharmacist, Emergency Medicine, Stanford Hospital and Clinics, Stanford, 
      California.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Hosp Pharm
JT  - Hospital pharmacy
JID - 0043175
PMC - PMC3839476
OTO - NOTNLM
OT  - adverse events
OT  - emergency department
OT  - ketamine
OT  - pediatric patients
OT  - procedural sedation
EDAT- 2014/01/15 06:00
MHDA- 2014/01/15 06:01
PMCR- 2013/02/01
CRDT- 2014/01/15 06:00
PHST- 2014/01/15 06:00 [entrez]
PHST- 2014/01/15 06:00 [pubmed]
PHST- 2014/01/15 06:01 [medline]
PHST- 2013/02/01 00:00 [pmc-release]
AID - hpj480210 [pii]
AID - 10.1310/hpj4802-134 [doi]
PST - ppublish
SO  - Hosp Pharm. 2013 Feb;48(2):134-42. doi: 10.1310/hpj4802-134.