Clinical Policy: Critical Issues in the Sedation of Pediatric Patients in the Emergency Department

Abstract

Emergency physicians routinely provide sedation and analgesia, monitor the respiratory and cardiovascular status, and manage critically ill patients of all ages. 1. Innes G Murphy M Nijssen-Jordan C et al. Procedural sedation and analgesia in the emergency department. Canadian Consensus Guidelines. J Emerg Med. 1999; 17: 145-156 Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar , 2. American College of Emergency PhysiciansRapid sequence intubation. Ann Emerg Med. 1997; 29: 573 PubMed Google Scholar , 3. Glauser J Mace SE Procedural sedation in the emergency department: regulations as promulgated by the Joint Commission on Accreditation of Healthcare Organizations and establishment of procedural sedation policy within the emergency department. in: Mace SE Ducharme J Murphy M Pain Management and Sedation: Emergency Department Management. McGraw-Hill, New York, NY2006: 15-21 Google Scholar The provision of safe and effective sedation and analgesia is an integral part of emergency medicine practice and a component of the core curriculum for emergency medicine residency programs. 4. Core Content Task Force IIThe model of the clinical practice of emergency medicine. Ann Emerg Med. 2001; 37: 745-770 Abstract Full Text Full Text PDF PubMed Google Scholar , 5. Task Force on the Core Content for Emergency Medicine RevisionCore content for emergency medicine. Ann Emerg Med. 1997; 29: 792-811 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar , 6. Hostetler MA Auinger P Szilagyi PG Parenteral analgesic and sedative use among ED patients in the United States: combined results from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 1992-1997. Am J Emerg Med. 2002; 20: 139-143 Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar Failure to adequately treat a patient’s pain can have negative consequences, the event potentially affecting later physiologic responses and behaviors. Appropriately treating pain and anxiety decreases patient suffering, facilitates medical interventions, increases patient/family satisfaction, improves patient care, and may improve patient outcome. 7. American Academy of Pediatrics and American Pain SocietyThe assessment and management of acute pain in infants, children, and adolescents. Pediatrics. 2001; 108: 793-797 Crossref PubMed Scopus (276) Google Scholar , 8. Mace SE Murphy M Pain management and procedural sedation: definitions and clinical emergency department management. in: Mace SE Ducharme J Murphy M Pain Management and Sedation: Emergency Department Management. McGraw Hill, New York, NY2006: 7-14 Google Scholar , 9. American Academy of Pediatrics and Canadian Paediatric SocietyPrevention and management of pain and stress in the neonate. Pediatrics. 2000; 105: 454-461 Crossref PubMed Google Scholar , 10. Anand KJ Clinical importance of pain and stress in preterm neonates. Biol Neonate. 1998; 73: 1-9 Crossref PubMed Scopus (246) Google Scholar