The Landscape of Pediatric Procedural Sedation in the United Kingdom and Irish Emergency Departments; an International Survey Study

ABSTRACT Approximately 250 000 children undergo pediatric procedural sedation (PPS) in Emergency Departments (ED) in the United Kingdom and Ireland annually. PPS practice in our setting has not been described as fully as other high‐income countries. We aimed to evaluate PPS in EDs in the United King...

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Main Authors: Dani Hall, Tadgh Moriarty, Damian Roland, Ronan O'Sullivan, Carol Blackburn, Stuart Hartshorn, Shrouk Messahel, Mark D. Lyttle, PERUKI
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Paediatric & Neonatal Pain
Subjects:
Online Access:https://doi.org/10.1002/pne2.12132
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author Dani Hall
Tadgh Moriarty
Damian Roland
Ronan O'Sullivan
Carol Blackburn
Stuart Hartshorn
Shrouk Messahel
Mark D. Lyttle
PERUKI
author_facet Dani Hall
Tadgh Moriarty
Damian Roland
Ronan O'Sullivan
Carol Blackburn
Stuart Hartshorn
Shrouk Messahel
Mark D. Lyttle
PERUKI
author_sort Dani Hall
collection DOAJ
description ABSTRACT Approximately 250 000 children undergo pediatric procedural sedation (PPS) in Emergency Departments (ED) in the United Kingdom and Ireland annually. PPS practice in our setting has not been described as fully as other high‐income countries. We aimed to evaluate PPS in EDs in the United Kingdom and Ireland. An online survey was distributed through Paediatric Emergency Research in the UK and Ireland (PERUKI), in June 2020. One respondent per ED completed the survey, including questions on agents, fasting, training, and governance. Of 72 PERUKI sites, 61 (85%) responded, of which PPS was performed in 50 (82%). Internal training packages existed in under half (22/50, 44.0%). Most had a guideline (43/50; 86.0%) and documentation proforma (39/50; 78.0%). Audit databases existed in 24/50 (48.0%). Intravenous ketamine was the most common agent (43/50; 86%), followed by variable concentration nitrous oxide (13/50; 26%). Fasting practices varied widely across sites and agents. We have demonstrated widespread PPS use, but non‐standardized practice. This leads to potential issues of risk and variability across agents, highlighting a need for a sedation package in the United Kingdom and Ireland to standardize practice and data collection. We propose development of a prospective ED sedation registry in the United Kingdom and Ireland to facilitate data collection to support research within this area.
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spelling doaj-art-0f989b632f334ef5959acb3bfad554f92025-08-20T01:49:59ZengWileyPaediatric & Neonatal Pain2637-38072025-03-0171n/an/a10.1002/pne2.12132The Landscape of Pediatric Procedural Sedation in the United Kingdom and Irish Emergency Departments; an International Survey StudyDani Hall0Tadgh Moriarty1Damian Roland2Ronan O'Sullivan3Carol Blackburn4Stuart Hartshorn5Shrouk Messahel6Mark D. Lyttle7PERUKIDepartment of Emergency Medicine Children's Health Ireland at Crumlin Dublin IrelandUniversity Hospital Waterford Waterford IrelandPaediatric Emergency Medicine Leicester Academic (PEMLA) Group, Children's Emergency Department Leicester Royal Infirmary Leicester UKSAPPHIRE Group, Population Health Sciences Leicester University Leicester UKDepartment of Emergency Medicine Children's Health Ireland at Crumlin Dublin IrelandBirmingham Women's and Children's NHS Foundation Trust Birmingham UKAlder Hey Children's Hospital Liverpool UKEmergency Department University Hospitals Bristol and Weston NHS Foundation Trust Bristol UKABSTRACT Approximately 250 000 children undergo pediatric procedural sedation (PPS) in Emergency Departments (ED) in the United Kingdom and Ireland annually. PPS practice in our setting has not been described as fully as other high‐income countries. We aimed to evaluate PPS in EDs in the United Kingdom and Ireland. An online survey was distributed through Paediatric Emergency Research in the UK and Ireland (PERUKI), in June 2020. One respondent per ED completed the survey, including questions on agents, fasting, training, and governance. Of 72 PERUKI sites, 61 (85%) responded, of which PPS was performed in 50 (82%). Internal training packages existed in under half (22/50, 44.0%). Most had a guideline (43/50; 86.0%) and documentation proforma (39/50; 78.0%). Audit databases existed in 24/50 (48.0%). Intravenous ketamine was the most common agent (43/50; 86%), followed by variable concentration nitrous oxide (13/50; 26%). Fasting practices varied widely across sites and agents. We have demonstrated widespread PPS use, but non‐standardized practice. This leads to potential issues of risk and variability across agents, highlighting a need for a sedation package in the United Kingdom and Ireland to standardize practice and data collection. We propose development of a prospective ED sedation registry in the United Kingdom and Ireland to facilitate data collection to support research within this area.https://doi.org/10.1002/pne2.12132fastingketaminenitrous oxidepediatric emergency medicinepediatric procedural sedation
spellingShingle Dani Hall
Tadgh Moriarty
Damian Roland
Ronan O'Sullivan
Carol Blackburn
Stuart Hartshorn
Shrouk Messahel
Mark D. Lyttle
PERUKI
The Landscape of Pediatric Procedural Sedation in the United Kingdom and Irish Emergency Departments; an International Survey Study
Paediatric & Neonatal Pain
fasting
ketamine
nitrous oxide
pediatric emergency medicine
pediatric procedural sedation
title The Landscape of Pediatric Procedural Sedation in the United Kingdom and Irish Emergency Departments; an International Survey Study
title_full The Landscape of Pediatric Procedural Sedation in the United Kingdom and Irish Emergency Departments; an International Survey Study
title_fullStr The Landscape of Pediatric Procedural Sedation in the United Kingdom and Irish Emergency Departments; an International Survey Study
title_full_unstemmed The Landscape of Pediatric Procedural Sedation in the United Kingdom and Irish Emergency Departments; an International Survey Study
title_short The Landscape of Pediatric Procedural Sedation in the United Kingdom and Irish Emergency Departments; an International Survey Study
title_sort landscape of pediatric procedural sedation in the united kingdom and irish emergency departments an international survey study
topic fasting
ketamine
nitrous oxide
pediatric emergency medicine
pediatric procedural sedation
url https://doi.org/10.1002/pne2.12132
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