Pediatric Sedation

 

 

Intravenous conscious sedation may be performed on pediatric patients greater than 9 months of age who are assessed Class I or Class II using the Physical Status Classification of the American Society of Anesthesiologists (ASA) System.

 

 

“A technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows patients to tolerate unpleasant procedures while maintaining cardiorespiratory function. Procedural sedation and analgesia is intended to result in a depressed level of consciousness, but one that allows the patient to maintain airway control independently and continuously,” Reference: American College of Emergency Physicians) ACEP

 

 

Age	Respiration Rate	Heart Rate	Arterial BP	Arterial BP
			Systolic	Diastolic
Neonates	40	140	65	45
12 Mths	30	120	95	65
3 yrs	25	100	100	70
12 yrs	20	80	110	60

American Association of Pediatrics NPO Guidelines for elective cases

• For children 0-5 months: no milk or solids for four hours
• No breast milk for 4 hours before scheduled procedure
• 5-36 months: no milk or solids for six hours
• > 3 years: 8 hours for milk or solids
• Clear liquids up to two hours beforehand

Who is qualified to do sedation?

• One practitioner – at least BLS, preferably PALS, and familiarity with drugs
• One assistant – primary responsibility is monitoring
• For deep sedation – practitioner must have advanced airway skills. (Anesthesia provider, Pediatric intensivists, ED physician)

Medications for Pediatric Sedation:

Midaz

Chloral Hydate