Abstract
BackgroundIn Italy, as in many European countries, Pediatric Emergency Medicine is not formally recognized as a pediatric subspecialty, hindering nation-wide adoption of standards of care, especially in the field of procedural sedation and analgesia (PSA) in the Emergency Department (ED). For this reason PSA in Italy is mostly neglected or performed very heterogeneously and by different providers, with no reference standard. We aimed to describe the procedures and results of the first multidisciplinary and multi-professional Consensus Conference in Italy on safe and effective pediatric PSA in Italian EDs.MethodsThe preparation, organization and conduct of the Consensus Conference, held in Florence in 2017, followed the recommended National methodological standards. Professionals from different specialties across the country were invited to participate.ResultsOverall 86 recommendations covering 8 themes (pre-sedation evaluation, pharmacologic agents, monitoring, equipment and discharge checklists, training, non-pharmacologic techniques, the adult ED setting, impact on hospitalizations) were developed, taking into account the Italian training system and healthcare organization characteristics.ConclusionThe results of the first multidisciplinary and multi-professional Consensus Conference in Italy are meant to provide up-to-date national guidance to improve the standard of care of children undergoing painful and stressful procedures in the ED. The recommendations will be periodically updated as new relevant evidence is published.
Highlights
Introductionprocedural sedation and analgesia (PSA) has long been standard practice to facilitate procedures for children in the Emergency Department (ED) in many countries [4, 10,11,12,13,14,15,16]
Children presenting to the emergency department (ED) often need painful, uncomfortable or stressful procedures or painless imaging that require immobility as part of their diagnostic workup or treatment [1,2,3,4,5]
To ensure a multidisciplinary and multi-professional representativeness of the Expert Panel (EP), professionals were invited from the fields of Adult and Pediatric Anesthesiology, Intensive Care, Emergency Medicine, Pediatric Emergency Medicine, Pediatrics, Nursing, and Psychology
Summary
PSA has long been standard practice to facilitate procedures for children in the ED in many countries [4, 10,11,12,13,14,15,16]. In Italy, as in many European countries, Pediatric Emergency Medicine is not formally recognized as a pediatric subspecialty, hindering nation-wide adoption of standards of care, especially in the field of procedural sedation and analgesia (PSA) in the Emergency Department (ED). For this reason PSA in Italy is mostly neglected or performed very heterogeneously and by different providers, with no reference standard.
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