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26 - Procedural Sedation for Pediatric Laceration Repair

from SECTION THREE - PROCEDURAL SEDATION FOR THE EMERGENCY PATIENT

Published online by Cambridge University Press:  03 December 2009

John H. Burton  and
James Miner
By
Mark G. Roback
John H. Burton
Affiliation:
Albany Medical College, New York
James Miner
Affiliation:
University of Minnesota
Mark G. Roback
Affiliation:
Professor, University of Minnesota Medical School, 76 Variety Club Research Center, MMC 814, 420 Delaware Street SE, Minneapolis, MN 55455
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Summary

SCOPE OF THE PROBLEM

In 2002 over 2.4 million children with lacerations were seen in emergency departments (ED) across the United States. Children have many characteristics that can make proper wound management and laceration repair challenging. Young age and anxiety preclude many children from being able to hold still sufficiently to facilitate proper wound care, even when appropriate analgesia has been administered. This frequently results in the need to control patient motion using procedural sedation. Three large, prospective series describing procedural sedation in children found that procedural sedation for laceration repair represents from 18% to 58% of all sedation provided to children.

In a recent survey, adults with traumatic lacerations were asked to report what they felt were the most important priorities regarding their care. The top priorities were return of normal function, avoiding infection, cosmetic outcome, and the least painful repair possible. Procedural sedation is administered to children with lacerations to facilitate wound management and repair, as well as to control pain, coinciding with the top priorities of adult patients receiving laceration repair.

Cost and length of stay were ranked less highly in this survey. The fact that patients were less concerned with the cost and length of stay related to their laceration care is important, as both have been found to be increased when sedation is provided to pediatric patients for minor laceration repair.

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Chapter
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Emergency Sedation and Pain Management , pp. 168 - 172
Publisher: Cambridge University Press
Print publication year: 2008

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References

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