• Maybritt I Kuypers, Smits Gaël J P GJP Department of Emergency., Eva P Baerends, Erick Oskam, Reijners Eef P J EPJ Emergency Department, St Elisabeth Hospital, Tilburg., Lisette A A Mignot-Evers, Thijssen Wendy A M H WAMH Department of Emergency., Frans B Plötz, and Erik H M Korsten.
• Academic Medical Centre, Amsterdam.
• Eur J Emerg Med. 2019 Jun 1; 26 (3): 168-173.

ObjectivesPaediatric patients receive less procedural sedation and analgesia (PSA) in the emergency department compared with adults, especially in countries where emergency medicine is at an early stage of development. The objectives of this study were to evaluate the adverse events and efficacy of paediatric PSA in a country with a recent establishment of emergency medicine and to describe which factors aided implementation.MethodsThis is a prospective, multicentre, observational study of paediatric patients undergoing PSA by the first trained emergency physicians (EPs) in The Netherlands. A standardized data collection form was used at all participating hospitals to collect data on adverse events, amnesia, pain scores, and procedure completion. A survey was used to interpret which factors had aided PSA implementation.ResultsWe recorded 351 paediatric PSA. The mean age was 9.5 years (95% confidence interval: 9.1-10.0). Esketamine was most frequently used (42.4%), followed by propofol (34.7%). The adverse event rate was low (3.0%). Amnesia was present in 86.8%. The median pain score was 2 (out of 10) for patients without amnesia. Procedures were successfully completed in 93.9% of the cases.ConclusionPaediatric PSA provided by the first EPs in The Netherlands showed appropriate levels of sedation and analgesia with a high rate of procedure completion and a low rate of adverse events. Our paper suggests that EPs provided with a proper infrastructure of mentorship, training and guidelines can implement effective paediatric PSA.

28 keywords...

hide…