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Introduction to Procedural Sedation Within and Outside the ICU

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Sedation and Analgesia for the Pediatric Intensivist

Abstract

Pediatric procedural sedation is a high-risk clinical activity that is ubiquitous in any hospital that cares for children. While no one pediatric subspecialty inherently owns sedation, PCCM physicians are frequently at the center of providing procedural sedation within an institution. On the surface, PCCM physicians, by virtue of their training, experience, and expertise, are well suited to perform procedural sedation on children. Yet, like many skills and competencies required in critical care, procedural sedation poses a number of special requirements and challenges to the PCCM practitioner.

The AAP monitoring and management guidelines for procedural sedation clarify the basic requirements necessary to promote safe sedation. These guidelines define levels of sedation on a continuum from minimal to deep sedation and underscore the importance of being able to rescue patients who progress to a deeper-than-planned level of sedation.

Provision of quality sedation practice requires a multifaceted approach to be successful. PCCM practitioners must have the necessary skills and competencies to deliver high-quality sedation. The structure of providing high-quality sedation practice must include a team knowledgeable and skilled in delivering sedation, a setting conducive to conducting safe and effective sedation and an organization of institutional policies and procedures that addresses quality of sedation practice. Finally, the process of promoting high-quality procedural sedation must be mindful to the ergonomic weaknesses to patient safety inherent within an institution’s framework and the importance of promoting high-quality teamwork, designing an effective physical layout, and reducing the frequency and impact of extraneous distractions.

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Authors and Affiliations

  1. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Kristin A. Tiedt, Juan P. Boriosi & Gregory A. Hollman

Authors
  1. Kristin A. Tiedt
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  2. Juan P. Boriosi
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  3. Gregory A. Hollman
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Correspondence to Gregory A. Hollman .

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Editors and Affiliations

  1. Associate Professor of Pediatrics, Emory University School of Medicine, Department of Pediatrics, Division of Pediatric Critical Care Medicine, Children’s Healthcare of Atlanta at Egleston, Atlanta, GA, USA

    Pradip P. Kamat

  2. Professor of Pediatrics/Pediatric Critical Care, University of Louisville, “Just For Kids” Critical Care Center, Norton Children’s Hospital, Louisville, KY, USA

    John W. Berkenbosch

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Tiedt, K.A., Boriosi, J.P., Hollman, G.A. (2021). Introduction to Procedural Sedation Within and Outside the ICU. In: Kamat, P.P., Berkenbosch, J.W. (eds) Sedation and Analgesia for the Pediatric Intensivist. Springer, Cham. https://doi.org/10.1007/978-3-030-52555-2_24

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  • DOI: https://doi.org/10.1007/978-3-030-52555-2_24

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