Book contents
- Frontmatter
- Contents
- Acknowledgments
- List of Contributors
- SECTION ONE OVERVIEW AND PRINCIPLES IN EMERGENCY ANALGESIA AND PROCEDURAL SEDATION
- SECTION TWO ANALGESIA FOR THE EMERGENCY PATIENT
- SECTION THREE PROCEDURAL SEDATION FOR THE EMERGENCY PATIENT
- 23 Patient Assessment and Preprocedure Considerations
- 24 Monitoring for Procedural Sedation
- 25 Pharmacology of Commonly Utilized Sedative Agents
- 26 Procedural Sedation for Pediatric Laceration Repair
- 27 Procedural Sedation for Pediatric Radiographic Imaging Studies
- 28 Procedural Sedation for Brief Pediatric Procedures: Foreign Body Removal, Lumbar Puncture, Bone Marrow Aspiration, Central Venous Catheter Placement
- 29 Procedural Sedation for Adult and Pediatric Orthopedic Fracture and Joint Reduction
- 30 Procedural Sedation for Electrical Cardioversion
- 31 Procedural Sedation for Brief Surgical Procedures: Abscess Incision and Debridement, Tube Thoracostomy, Nasogastric Tube Placement
- SECTION FOUR TOPICAL, LOCAL, AND REGIONAL ANESTHESIA APPROACH TO THE EMERGENCY PATIENT
- SECTION FIVE SPECIAL CONSIDERATIONS FOR EMERGENCY PROCEDURAL SEDATION AND ANALGESIA
- Index
- Plate section
- References
28 - Procedural Sedation for Brief Pediatric Procedures: Foreign Body Removal, Lumbar Puncture, Bone Marrow Aspiration, Central Venous Catheter Placement
from SECTION THREE - PROCEDURAL SEDATION FOR THE EMERGENCY PATIENT
Published online by Cambridge University Press: 03 December 2009
- Frontmatter
- Contents
- Acknowledgments
- List of Contributors
- SECTION ONE OVERVIEW AND PRINCIPLES IN EMERGENCY ANALGESIA AND PROCEDURAL SEDATION
- SECTION TWO ANALGESIA FOR THE EMERGENCY PATIENT
- SECTION THREE PROCEDURAL SEDATION FOR THE EMERGENCY PATIENT
- 23 Patient Assessment and Preprocedure Considerations
- 24 Monitoring for Procedural Sedation
- 25 Pharmacology of Commonly Utilized Sedative Agents
- 26 Procedural Sedation for Pediatric Laceration Repair
- 27 Procedural Sedation for Pediatric Radiographic Imaging Studies
- 28 Procedural Sedation for Brief Pediatric Procedures: Foreign Body Removal, Lumbar Puncture, Bone Marrow Aspiration, Central Venous Catheter Placement
- 29 Procedural Sedation for Adult and Pediatric Orthopedic Fracture and Joint Reduction
- 30 Procedural Sedation for Electrical Cardioversion
- 31 Procedural Sedation for Brief Surgical Procedures: Abscess Incision and Debridement, Tube Thoracostomy, Nasogastric Tube Placement
- SECTION FOUR TOPICAL, LOCAL, AND REGIONAL ANESTHESIA APPROACH TO THE EMERGENCY PATIENT
- SECTION FIVE SPECIAL CONSIDERATIONS FOR EMERGENCY PROCEDURAL SEDATION AND ANALGESIA
- Index
- Plate section
- References
Summary
SCOPE OF THE PROBLEM
The pediatric population accounts for a large percentage of emergency department (ED) visits annually. Many of these patients will require brief, painful procedures either in the ED or in another setting such as the intensive care unit. These procedures also occur frequently in the outpatient clinic or inpatient setting for children with chronic illnesses. To affect an optimal procedural experience for these patients, a pediatric procedure unit or clinical response team of well-trained caregivers has been a recent trend.
Typical procedures for these patients include lumbar puncture, bone marrow aspiration, and central venous catheter placement. These procedures, and other brief diagnostic and therapeutic procedures in this population, are similar to the adult population in the intervention and technique required. They are distinct from their adult counterparts, however, in that the pediatric patient will often require sedation and anxiolysis owing to the child's fear, in addition to a need to create an experience that is positive and supportive instead of a recurrent, negative association with medical care. Younger patients will also often require a brief period of sedation to optimize positioning or minimize movement.
It has been previously documented that there is considerable underuse of analgesia and sedation in children requiring brief, painful medical interventions. The goal of procedural sedation in this setting is to provide sedative, analgesic, and/or dissociative agents to alter recognition of pain and level of consciousness, at the same time maintaining airway reflexes in order to provide symptomatic relief of pain and anxiety.
- Type
- Chapter
- Information
- Emergency Sedation and Pain Management , pp. 179 - 184Publisher: Cambridge University PressPrint publication year: 2008