Paediatric procedural sedation using ketamine in a UK emergency department: a 7 year review of practice

Kidd, Lawrence R; Lyons, Sharon; Lloyd, Gavin

doi:10.1093/bja/aev555

Cited by 30 publications

(20 citation statements)

References 46 publications

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“…A relative sparing of effects on protective airway reflexes makes ketamine useful, especially for non-fasting procedures [20]. The increase in blood pressure and pulse associated with ketamine administration maintains the cardiac output; however, in critically ill patients having depleted catecholamine, ketamine can lead to marked hypotension or bradycardia and even cardiac arrest [21].…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Procedural Sedation and Analgesia in Pediatric Oncology Patients

Aslam¹,

Haque²,

Jamil³

et al. 2020

Cureus

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Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Procedural Sedation and Analgesia in Pediatric Oncology Patients

Aslam¹,

Haque²,

Jamil³

et al. 2020

Cureus

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“…The tool was intended to present a taxonomy of sedation outcomes which would be objective and reproducible. By adopting this taxonomy worldwide, particularly valuable in areas with neither organized sedation systems nor prior means of collecting and reporting their own outcomes, all sedation providers now have a means of tracking and sharing their outcomes through the AE sedation reporting tool database [26,29,31,[34][35][36]. This tool is a repository of sedation-related data inputted from all sedation providers worldwide and is a means to report on sedation demographics and outcomes, with the objective of presenting a hierarchical structure to predict the occurrence, risk, and outcome of adverse events ( Figure 1, Table 1, Table 2).…”

Section: Methodsmentioning

confidence: 99%

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Mason

Roback

Chrisp

et al. 2019

JCM

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Background: The incidence of sedation-related adverse events, inclusive of both adults and children, administered by multiple specialty providers from different countries and venues, using standardized definitions, has never been reported on an international level. We are reporting the outcome data of the adverse event sedation reporting tool as an important step toward a more complete risk assessment of sedation-related morbidity, mortality, and etiology. The analysis of the AE sedation reporting data include descriptive measures to evaluate the characteristics of the provider, the patient, sedations performed, adverse events, interventions, and outcomes. The primary outcome was the rate and nature of adverse events. Between 12/14/2010 and 12/11/2018 there were 7952 sedations, from an estimated total of 164,114 sedations administered, of which 622 were reported as adverse events. The mean age of the entire patient population is 33.0 years (0.02-98.7). The providers represented 39 countries across six continents. Oxygen desaturation (75%-90%) for <60 s is the most prevalent adverse event with a rate of 7.8 per 10,000, followed by airway obstruction at a rate of 5.42 per 10,000. Apnea occurred at a rate of 4.75 per 10,000. Significant predictors of adverse events are ≥ ASA score III (p = 0.0003), procedure time (6:00 pm-12:00 am: p < 0.0001, 12:00-6:00 am: p = 0.0003), and non-hospital location (p < 0.0001). The AE sedation reporting tool has demonstrated that the majority of adverse events in children and adults who receive procedural sedation from multi-specialists internationally required minor interventions and had outcomes of minor risk.

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“…Part of this issue is the immense variability in sedation-related adverse event reporting. The ‘Adverse Events Sedation Reporting Tool’ has recently been developed by the World Society of Intravenous Anaesthesia36 and has already been successfully trialled 37 38. This tool includes a description of the adverse event and its severity, the interventions performed and the outcome.…”

Section: Discussionmentioning

confidence: 99%

Capnography for procedural sedation in the ED: a systematic review

et al. 2016

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There is no firm evidence that capnography provides additional safety compared with standard monitoring alone during PSA in adults in the ED. There is a paucity of published research involving preoxygenated patients who remain on high-flow oxygen throughout PSA. Well-powered randomised controlled trials, employing an accepted adverse event reporting tool in such patients, are required. Until then, we advocate continued compliance with current professional recommendations for the use of capnography during PSA in adults in the ED.

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Paediatric procedural sedation using ketamine in a UK emergency department: a 7 year review of practice

Abstract: These data support the ongoing use of ketamine for paediatric procedural sedation in the emergency department by emergency physicians. Relatively high resource requirements mean that ensuring adequate numbers of procedures may prove challenging.

Cited by 30 publications

References 46 publications

Safety and Efficacy of Procedural Sedation and Analgesia in Pediatric Oncology Patients

Safety and Efficacy of Procedural Sedation and Analgesia in Pediatric Oncology Patients

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Capnography for procedural sedation in the ED: a systematic review

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