1682 Nice (UK) Guidelines for Sedation in Children: Need for a Pragmatic Approach?

• Published in: Archives of disease in childhood 2012-10, Vol.97 (Suppl 2), p.A475-A476
• Main Authors: Erumbala, G, Misra, I, Chawda, N
• Format: Article
• Language: English
• Subjects: Guidelines; Health care; Heart rate
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2012-302724.1682

Introduction National Institute of Clinical Excellence (NICE-UK) guidelines covering sedation for diagnostic and therapeutic procedures has laid out recommendations for pre-sedation preparation, monitoring during the sedation along with training and skills required for health care professionals. The following survey was conducted to identify the sedation practices in various centres across UK. Methods Online questionnaire based on the Key Priorities of implementation (KPIs) of the guidelines. Our centre was excluded. Results 20 units participated in the survey. The pre-sedation check list for most of the centres (94.7 to 100%) took into account medical background, anthropometric & airway assessments; however, only 6 (31.6%) centres included psychological and developmental status. NICE (UK) recommends anesthetist advice for sedating children < 1 year- only 2 (10.5%) responses confirmed this. 8 centres (42.1%) ensured that sedation process was overseen by 2 healthcare professionals. In 5 centres (26.3%), the professional delivering sedation did not hold Advanced Paediatric Life Support qualification. 84.2–100% of the participating centres reported that oxygen saturations, respiration and heart rate were monitored routinely; BP was monitored by 7 (36.8%), and ECG monitoring by 2 centres (10.5%). 5 (26.3%) centres reported at least one adverse cardiorespiratory event during sedation. Conclusion We could not identify any centres that were able to implement the KPIs fully for routine scan sedations, raising questions about possible practical issues. This warrants further exploration into the practical experiences of different centres. We hope to initiate a discussion aiming to weigh the benefits and practical difficulties of the sedation guidelines.