Recommendations for non-anaesthesia providers in sedation and analgesia procedures

• Published in: Anales de Pediatría 2022-12, Vol.97 (6), p.422.e1-422.e10
• Main Authors: Sánchez-Malo, María José, Llorens-Córcoles, Ana María, Marcote-Martínez, Belén Fernández, Alonso-Salas, María Teresa, Míguez-Navarro, María Concepción
• Format: Article
• Language: English
• Subjects: anaesthesia; Analgesia; Analgesia - methods; anestesia; Child; conscious sedation; Conscious Sedation - methods; emergency department; Emergency Service, Hospital; Humans; manejo del dolor; Pain; Pain Management; sedación consciente; servicio de urgencias
• ISSN: 2341-2879; 2341-2879
• DOI: 10.1016/j.anpede.2022.09.009

Pain and the anxiety that it produces are the main sources of suffering in children managed in emergency departments, eliciting a growing interest in parents and health care providers in the adequate provision of sedation and analgesia. In consequence, the number of diagnostic and therapeutic procedures that require sedation and/or analgesia in paediatric emergency departments has increased in recent years, which has generated a need to train non-anaesthesiologists on how to provide this care without affecting patient safety. The objective of this document is to establish evidence-based recommendations, developed by consensus by the Working Group on Sedation and Analgesia of the Sociedad Española de Urgencias de Pediatría, regarding the competencies and training of staff who perform sedation or analgesia procedures to achieve the greatest possible quality in the management of paediatric patients before, during and after these procedures in the paediatric emergency care setting. The consensus document has been structured in two parts: the first addresses the competencies of non-anaesthesiologists who perform sedoanalgesia procedures, and the second how to obtain the necessary training. A list of research questions was prepared, keywords defined and a literature search carried out to break down and summarise the available evidence. The results are presented in the form of conclusions, which were subjected to anonymous voting by each of the members of the working group. For each of the conclusions, we provide the percent agreement obtained in the voting El dolor, y la ansiedad que éste produce, son las primeras causas de sufrimiento en los niños que acuden a los servicios de urgencias, motivando un aumento del interés de padres y sanitarios para proporcionar una adecuada analgesia y sedación. Por ello, en los últimos años, se ha producido un incremento en el número de procedimientos diagnósticos y terapéuticos en niños que requieren sedoanalgesia en urgencias pediátricas, lo que ha originado una necesidad de formación de personal no anestesiólogo para cubrir ese requisito sin afectar a la seguridad del paciente. El objetivo de este documento de consenso es establecer recomendaciones basadas en la evidencia científica, elaboradas y consensuadas por el Grupo de Trabajo de Sedoanalgesia de la Sociedad Española de Urgencias de Pediatría, sobre las competencias y la capacitación del personal que realiza procedimientos de sedoanalgesia para conseguir un óptimo mane