Validation of the Ramsay scale for invasive procedures under deep sedation in pediatrics

Background The Ramsay scale is the most widely used scale during pediatric procedures although it has not been formally validated. Objective To validate the Ramsay scale during invasive procedures under sedation in pediatrics. Methods A prospective analytic study was conducted in two hospitals. All...

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Bibliographic Details
Published in:Pediatric anesthesia 2021-10, Vol.31 (10), p.1097-1104
Main Authors: Lozano‐Díaz, David, Valdivielso Serna, Alberto, Garrido Palomo, Ramón, Arias‐Arias, Ángel, Tárraga López, Pedro J., Martínez Gutiérrez, Andrés, Cravero, Joseph
Format: Article
Language:English
Subjects:
Anesthesia
Child
concordance
Conscious Sedation
Deep Sedation
Humans
Hypnotics and Sedatives
invasive procedure
Monitoring, Physiologic - methods
Pediatrics
Prospective Studies
Ramsay scale
Reproducibility of Results
validation
Validation studies
Validity
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Summary:Background The Ramsay scale is the most widely used scale during pediatric procedures although it has not been formally validated. Objective To validate the Ramsay scale during invasive procedures under sedation in pediatrics. Methods A prospective analytic study was conducted in two hospitals. All patients ≥6 months that were undergoing invasive procedures under sedation were enrolled. All were recorded, and these videos were edited and randomized. 150 videos were scored by four observers (a pediatrician, a pediatric intensive care unit nurse, an anesthetist, and an operating room nurse). All videos were scored with the Ramsay scale and University of Michigan Sedation Scale. Observers were blinded to drug administration. Construct validity was measured through Wilcoxon test paired samples after administration of sedatives. Criterion validity, intra‐observer reliability, and interobserver correlation were evaluated by comparing the scores of the scales using Spearman’s correlation coefficient. Interobserver agreement was measured using the intraclass correlation coefficient. To assess test‐retest reliability, 50 videos were randomly selected and reevaluated. Results Sixty‐five patients were included. Construct validity was demonstrated through changes in the Ramsay scale scoring after administration of sedatives (p 
ISSN:1155-5645
1460-9592
DOI:10.1111/pan.14248