What are the benefits of pediatric sedation administered in the emergency department (ED)?

Updated: May 08, 2018
  • Author: Wan-Tsu Wendy Chang, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Pain and anxiety are common problems in the emergency department (ED). By relieving pain, the emergency provider can render the patient less anxious and more cooperative, thereby potentially achieving a better outcome. Fear, anxiety, and early developmental stage may make it difficult for a child to cooperate with necessary procedures. Failure to cooperate is likely to result in a suboptimal outcome.

Pain in children historically has been underreported, undertreated, and misunderstood. Until comparatively recently, children too young to verbalize were also considered too young to experience pain or fear, and they often received no analgesia, even after major surgery. However, it is now known that even neonates show a physiologic response to painful stimuli. In addition, research has shown that children often do not receive the same treatment as adults with similar painful conditions. Age is apparently a risk factor for oligoanalgesia.

Unfortunately, the current practice of many EDs is not standardized. Many centers and practitioners do not use premedication for children undergoing painful procedures. Reasons for inadequate treatment include failure to recognize pain, ignorance about drugs and dosages, fear of adverse cardiovascular effects, and fear of delay in treatment and disposition.

The practice of pediatric sedation is evolving. [4, 5] Accordingly, this article’s objectives are as follows:

  • To discuss current indications for and goals of sedation in children

  • To emphasize proper preparation and monitoring during procedures

  • To discuss methods of drug administration and specific agents

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