• G P Conners, W K Sacks, and N F Leahey.
• Department of Emergency Medicine, University of Rochester Medical Center, New York 14642, USA.
• Pediatr Emerg Care. 1999 Aug 1; 15 (4): 241-4.

ObjectiveTo characterize variations among pediatric emergency physicians and their hospital facilities regarding sedation of the uncooperative, stable child for head CT following closed head injury.DesignMail survey with two follow-up mailings.ParticipantsSurveys were sent to all members of the Emergency Medicine Section of the American Academy of Pediatrics (AAP).ResultsOf 596 surveys sent, 431 (72%) were returned, with 304 (51%) usable responses. Respondents annually sedate over 17,500 children for post-traumatic head CT. Formal training to sedate children for head CT was noted by 73%. Published guidelines for sedation are followed by 74%; 10% were unaware of the existence of published guidelines for sedation. Twenty-six percent of the respondents were very or somewhat dissatisfied with their sedation-related practices. In response to three clinical scenarios involving sedation of 8-month-old, 3-year-old, and 6-year-old children for head CT, midazolam was the most commonly chosen drug. Over 20 different sedation strategies were selected for each scenario.ConclusionsSedation practices for post-traumatic pediatric head CT vary widely, among both physicians and individual practitioners. Institutional and individual sedation-relation policies vary widely as well. Variation and dissatisfaction with sedation practices may reflect uncertainty regarding optimal sedation strategies. Further cost-effectiveness research is necessary.

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