Document Detail


Sedation provider practice variation: a survey analysis of pediatric emergency subspecialists and fellows.
MedLine Citation:
PMID:  20881903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Pediatric emergency physicians use various techniques and medications when performing procedural sedation and analgesia. The goals of our study were to assess US pediatric emergency medicine subspecialists and fellows (PEMSSFs) for individual practice variation and to evaluate (1) the use of supplemental oxygen and capnography monitoring and (2) adverse sedation events (ADSEs).
METHODS: A Web-based tool was used to survey and analyze data collected from a selected group of PEMSSFs, regarding their responses to 5 common sedation case scenarios, use of supplemental oxygen and capnography monitoring, and ADSEs. Logistic regression analysis was used to examine the association between medication strategy and various levels of professional experience.
RESULTS: Two hundred one surveys were received. One hundred ninety-five of these were eligible for the study: 140 from specialists and 55 from fellows. Respondents used multiple combinations of pharmaceutical agents to the scenarios presented. For some scenarios, statistical association was found between medication selection strategy and longer professional experience. Sixty percent of respondents do not routinely provide oxygen supplementation. Despite current guidelines supporting the routine use of capnography monitoring, 45% of respondents never use it. Adverse sedation event was reported in 17 cases; all patients were discharged with no further complications. A statistical association was found between years of practitioner experience and the likelihood of reporting an ADSE (P < 0.018).
CONCLUSIONS: This group of PEMSSFs reported a wide spectrum of medication sedation strategies, dichotomous approaches to the use of oxygen supplementation and capnography monitoring, and a low rate of ADSEs.
Authors:
Itai Shavit; Marc Leder; Daniel M Cohen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric emergency care     Volume:  26     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-08     Completed Date:  2011-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  742-7     Citation Subset:  IM    
Affiliation:
Emergency Department, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel. i_shavit@rambam.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Adult
Capnography / utilization
Conscious Sedation / adverse effects,  methods,  statistics & numerical data*
Data Collection
Deep Sedation / adverse effects,  methods,  statistics & numerical data*
Drug Utilization
Emergency Medicine*
Emergency Service, Hospital
Fellowships and Scholarships
Female
Humans
Hypnotics and Sedatives / adverse effects,  therapeutic use
Male
Middle Aged
Oxygen Inhalation Therapy / utilization
Pain / prevention & control
Pediatrics*
Physician's Practice Patterns / statistics & numerical data*
Professional Practice / statistics & numerical data
Psychomotor Agitation / prevention & control
United States
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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