The American Association Pediatric (AAP) suggest
That all patients through 17 years of age be considered pediatric patients.
Intravenous conscious sedation may be performed on pediatric patients greater than 9 months of age who are assessed Class I or Class II using the Physical Status Classification of the American Society of Anesthesiologists (ASA) System.
Procedural Sedation
“A technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows patients to tolerate unpleasant procedures while maintaining cardiorespiratory function. Procedural sedation and analgesia is intended to result in a depressed level of consciousness, but one that allows the patient to maintain airway control independently and continuously,” Reference: American College of Emergency Physicians) ACEP
Age | Respiration Rate | Heart Rate | Arterial BP | Arterial BP |
---|---|---|---|---|
Systolic | Diastolic | |||
Neonates | 40 | 140 | 65 | 45 |
12 Mths | 30 | 120 | 95 | 65 |
3 yrs | 25 | 100 | 100 | 70 |
12 yrs | 20 | 80 | 110 | 60 |
American Association of Pediatrics NPO Guidelines for elective cases
- For children 0-5 months: no milk or solids for four hours
- No breast milk for 4 hours before scheduled procedure
- 5-36 months: no milk or solids for six hours
- > 3 years: 8 hours for milk or solids
- Clear liquids up to two hours beforehand
Who is qualified to do sedation?
- One practitioner – at least BLS, preferably PALS, and familiarity with drugs
- One assistant – primary responsibility is monitoring
- For deep sedation – practitioner must have advanced airway skills. (Anesthesia provider, Pediatric intensivists, ED physician)
Medications for Pediatric Sedation: