Validation of the Pediatric Sedation State Scale

Cravero, Joseph P.; Askins, Nissa; Sriswasdi, Patcharee; Tsze, Daniel S; Zurakowski, David; Sinnott, Sean

doi:10.1542/peds.2016-2897

Cited by 54 publications

(34 citation statements)

References 20 publications

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“…In spite of that, we claim that higher levels of sedation were achieved in our study in comparison with Khatavkar and Bakhsh [19] who used a sedation scale adapted from Wilton and Colleagues [3]. We used Pediatric Sedation State Scale (PSSS) [11] and the results showed that the IM group achieved a higher score of sedation at 10 min point than the IN group and the same level of sedation at 20 and 30 min.…”

Section: Discussioncontrasting

confidence: 54%

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Effectiveness and safety of Ketamine and Midazolam mixture for procedural sedation in children with mental disabilities: A randomized study of intranasal versus intramuscular route

Wasfy

Hassan

Hashim

2020

Egyptian Journal of Anaesthesia

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Background: Sedation outside the operating room is challenging especially for mentally disabled children. The intravenous sedation is an effective way of drug administration, but it is difficult to insert. The intramuscular route still has fear of injection. The intranasal route can be an effective, needleless, and painless approach for procedural sedation. Methods: 40 children with a mental disability aged from 4-12 years classified as ASA class I and II were included after parents' approval for procedural sedation. They were divided into two groups; IN who received intranasal Midazolam 0.2 mg/kg and Ketamine 5 mg/kg and group IM who received the same dose intramuscularly. The heart rate, oxygen saturation and mean arterial blood pressure were recorded. We used the Pediatric Sedation State Scale to assess the level of sedation of children. Also, the satisfaction of the parents and complications were recorded. Results: The onset of sedation showed no statistical difference between the two groups while the duration of sedation and the time of discharge from the post-anesthesia care unit were significantly higher in the IM group. The sedation score was statistically higher in the IM group at 10 minutes while in 20 and 30 minutes it showed no statistically significant difference with comparable sedation state. Parents of IN group showed a statistically significant higher level of satisfaction. Conclusion: Midazolam and Ketamine mixture given through the nasal route with nasal atomization device is a needleless approach and as effective and safe as an intramuscular route for procedural sedation in mentally disabled children.

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Section: Discussioncontrasting

confidence: 54%

“…Sedation level after 10, 20 and 30 min were evaluated by the Pediatric Sedation State Scale (PSSS) [11] as follows:…”

Section: Methodsmentioning

confidence: 99%

Effectiveness and safety of Ketamine and Midazolam mixture for procedural sedation in children with mental disabilities: A randomized study of intranasal versus intramuscular route

Wasfy

Hassan

Hashim

2020

Egyptian Journal of Anaesthesia

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“…An additional adverse consequence of this taxonomy is that, given the inherent subjectivity of these definitions, their incorporation into guidelines and policy has fomented semantic disputes regarding procedural sedation boundaries, eg, what is the dividing line between moderate and deep sedation, and between deep sedation and general anesthesia? [44][45][46]49,50,53 Modern procedural sedation practice is best served by focusing on patient responsiveness when the intent is to ensure effectiveness, 54 while focusing on ventilatory adequacy when the intent is to ensure safety, 49,50 with both assessments occurring concurrently throughout the procedural sedation encounter. Cardiovascular stability is of similarly vital concern; however clinically important hemodynamic alterations are rare in patients without serious systemic disease or acute cardiovascular compromise.…”

Section: Ventilatory Adequacy Versus Responsivenessmentioning

confidence: 99%

Unscheduled Procedural Sedation: A Multidisciplinary Consensus Practice Guideline

Green¹,

Roback²,

Krauss³

et al. 2019

Annals of Emergency Medicine

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(ACEP) organized a multidisciplinary effort to create a clinical practice guideline specific to unscheduled, time-sensitive procedural sedation, which differs in important ways from scheduled, elective procedural sedation. The purpose of this guideline is to serve as a resource for practitioners who perform unscheduled procedural sedation regardless of location or patient age. This document outlines the underlying background and rationale, and issues relating to staffing, practice, and quality improvement. [

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“…Patients were finally carried back to the ward or emergency department's room until complete recovery. Oxygen saturation, respiratory rate, heart rate, blood pressure, end tidal CO 2 (EtCO 2 ), and Pediatric Sedation State Scale (PSSS) score 15 (Figure S1) were recorded continuously, every 5 minutes, from the beginning of the sedation until complete recovery, defined by NICE guidelines 16 as a complete return to presedation state.…”

Section: Methodsmentioning

confidence: 99%

Dexmedetomidine for EEG sedation in children with behavioral disorders

et al. 2020

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Diagnostic and therapeutic procedures are often difficult to perform in pediatric population due to a low compliance. Electroencephalogram (EEG) recording represents a particular challenge: The child should be quiet for a medium-long time and an EEG registration during spontaneous sleep is often necessary for a complete assessment. Even if a dedicated environment and adequate preparation of both child and parents make it usually easy to be successfully performed, it could become difficult in children

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Validation of the Pediatric Sedation State Scale

Abstract: The PSSS is a 6-point scale that is a valid measure of the effectiveness and quality of procedural sedation in children within the limits of the testing method used in this study.

Cited by 54 publications

References 20 publications

Effectiveness and safety of Ketamine and Midazolam mixture for procedural sedation in children with mental disabilities: A randomized study of intranasal versus intramuscular route

Effectiveness and safety of Ketamine and Midazolam mixture for procedural sedation in children with mental disabilities: A randomized study of intranasal versus intramuscular route

Unscheduled Procedural Sedation: A Multidisciplinary Consensus Practice Guideline

Dexmedetomidine for EEG sedation in children with behavioral disorders

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