Procedural sedation for pediatric patients in the emergency department at King Khalid University Hospital, Riyadh, K.S.A

Abstract

Procedural sedation and analgesia (PSA) has become the standard of care for diagnostic and therapeutic procedures undertaken in the Emergency Department (ED). In the Pediatric Emergency Department (PED) of King Khalid University Hospital (KKUH), which is a major teaching hospital in Riyadh Kingdom of Saudi Arabia we developed a standard protocol for PSA since 2005. The aim of this article is to report the experience at KKUH in pediatric PSA. Objectives: To report the experience at KKUH in pediatric PSA. Materials and Methods: Retrospective cross-sectional study of all cases who underwent PSA for painful procedures in Pediatric Emergency at KKUH from December 2005 to July 2008. Results: A total of 183 patients were reviewed. 179 patients were analyzed. Age ranges from 4 months to 13 years (mean 6 years). Nearly 66% were male. Ketamine was the most commonly used drug. Reduction of fracture/dislocation was the most common indication for sedation. Adverse events were identified in only 5.6% of patients. Vomiting was the most common recorded side-effect. The length of stay in the ED was ranging from 28 to 320 min (mean 111 min). Conclusion: Intravenous Ketamine is a consistently effective method of producing a rapid, brief period of adequate sedation and analgesia in children in the ED with no major side-effects noted in our experience.

Keywords

• Ketamine
• midazolam
• pediatric emergency
• procedural sedation and analgesia