1. Rule out treatable causes of agitation (a) Hypoxia and hypercarbia (b) Cerebral hypoperfusion (c) Bladder distention (d) Surgical lesion—necrotic bowel or compartment syndrome 2. Perform a presedation evaluation of the patient. This evaluation is similar…
American Academy of Pediatrics American Academy of Pediatric Dentistry American Academy of Periodontology American Association of Critical-Care Nurses American College of Critical Care Medicine American College of Emergency Physicians American…
Fig. 8.1 Pressure–volume curves of the (a) infant and (b) adult respiratory systems. The rest volume is the volume at zero intrathoracic pressure, where the outward recoil of the chest…
Status Disease state I No organic, physiologic, biochemical, or psychiatric disturbance II Mild to moderate systemic disturbance that may or may not be related to the reason for procedure, e.g.,…
Adverse events Interventions performed in response 1. Oxygen desaturation • Vigorous tactile stimulation • Airway repositioning • Suctioning • Oral or nasal airway placement 2. Apnea: central versus obstructive (partial versus complete) • Administration of reversal agents…
Item Behavioral Definition Score Cry No cry 1 Child is not crying Moaning 2 Child is moaning or quietly vocalizing silent cry Crying 2 Child is crying, but the cry…
Sedation measures • Adverse events related to sedation • Adverse events related to procedure • Procedure completion rate • Procedure times • Patient recovery times • Patient satisfaction • Parent satisfaction • Provider satisfaction • Cost • Speed of recovery…
New levels (as yet unnamed) Escalating risk of serious adverse event Physiological monitoring parameters (singular or combination)a Recommended sedationist skill set Recommended resourcesb 1 ≤1:10,000 Consistent with normal awake pattern…
Symptom Prevalence Fatigue 83 % Dyspnea 50–63 % Malaise/restlessness 40 % Pain 25–48 % Confusion 36 % Anxiety 31 % Depression 28 % Agitation 21 % Nausea/vomiting 6–25 % More…
Reported practices Associated potentially serious consequences • Unmonitored PSA during magnetic resonance imaging (MRI) • Not discovering in time potentially dangerous side effects (respiratory depression, hypoxia or bradycardia) • No formal monitoring, observation,…
