Current sedation practices in paediatric audiology clinics in gauteng, South Africa

Abstract

AimThe aim was to describe the current practices in sedation during AEP testing in infants and young children in Gauteng. MethodsAn exploratory qualitative research design was employed, where telephonic and face-to face interviews were conducted with 48 participants in paediatric audiology clinics that have AEP testing facilities in Gauteng, South Africa. Qualitative analysis was done, with inductive thematic analysis used for open ended questions. ResultsFindings revealed that 38% of the participants, majority of which were testing children under the age of 2 years, utilised natural sleep during testing, with only 29% utilizing conscious sedation. While all participants ensured pre-procedure fasting, findings revealed that 83% did not have or were unsure about the availability of monitoring methods, 63% had no emergency equipment, while 67% had no recovery and discharge criteria in their clinics. Conscious sedation at the outpatient clinic was mostly conducted by a registered nurse/an Ear, Nose & Throat specialist, with the anaesthesiologist serving in this role for AEP testing in theatre under general anaesthesia. Oral chloral hydrate and promethazine are the most commonly used medications, with melatonin also listed for conscious sedation. Propofol is the most commonly used for AEP testing in theatre. Three challenges were identified and these add to the implications raised by current findings. ConclusionCurrent findings have implications for audiological assessment of the difficult-to-test population in this context; with a need for resource availability and access deliberations highlighted.