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
26 - Procedural Sedation for Pediatric Laceration Repair
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
In 2002 over 2.4 million children with lacerations were seen in emergency departments (ED) across the United States. Children have many characteristics that can make proper wound management and laceration repair challenging. Young age and anxiety preclude many children from being able to hold still sufficiently to facilitate proper wound care, even when appropriate analgesia has been administered. This frequently results in the need to control patient motion using procedural sedation. Three large, prospective series describing procedural sedation in children found that procedural sedation for laceration repair represents from 18% to 58% of all sedation provided to children.
In a recent survey, adults with traumatic lacerations were asked to report what they felt were the most important priorities regarding their care. The top priorities were return of normal function, avoiding infection, cosmetic outcome, and the least painful repair possible. Procedural sedation is administered to children with lacerations to facilitate wound management and repair, as well as to control pain, coinciding with the top priorities of adult patients receiving laceration repair.
Cost and length of stay were ranked less highly in this survey. The fact that patients were less concerned with the cost and length of stay related to their laceration care is important, as both have been found to be increased when sedation is provided to pediatric patients for minor laceration repair.
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- Chapter
- Information
- Emergency Sedation and Pain Management , pp. 168 - 172Publisher: Cambridge University PressPrint publication year: 2008