Procedural sedation

Abstract

1. A careful history and examination of the child is essential and should not be rushed. Inquiring about certain risk factors that can potentially complicate procedural sedation is important. These include previous history of difficulty with intubation or anesthesia, snoring, presence of rhinorrhea, or cough. The examiner should assess neck mobility, mouth opening, dentition, and the presence of facial or airway anomalies. 2. The class of medicines (opioids, benzodiazepines, ketamine, etc.) does not solely determine the depth of sedation or risk for complications. The dosing of these medications and the way they are administered or co-administered determine the safety and efficacy of the procedural sedation. 3. Any provider administering sedation must be able to adequately "rescue" a child from a complication or medication-related adverse effect. This includes the need to "rescue" a child that transitions into a deeper level of sedation than intended.