Since more children are having medical and dental procedures that require sedation, The American Academy of Pediatrics (AAP) updated its pediatric sedation guidelines in a new clinical report. “Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016,” was published in the July 2016 Pediatrics and on its website.
The AAP and the American Academy of Pediatric Dentistry collaborated to unify recommendations used by medical and dental practitioners and provide clarification and updates of prior guidelines. The report includes a new requirement to monitor expired carbon dioxide to ensure airway patency and gas exchange, making sedation monitoring nearly identical to the requirements for general anesthesia.
The sedation of children differs from adults, and is used to guard the patient’s safety and welfare; relieve pain and anxiety, as well as to modify behavior and/or movement to allow the safe completion of the procedure.
The potential for a life-threatening event, such as apnea or airway obstruction, requires a sufficient number of people to carry out the procedure and monitor the patient. The report says studies show it is common for children to pass from the intended level of sedation to a deeper, unintended level of sedation – and calls for a person, in addition to the practitioner, to monitor the patient and assist in any supportive or resuscitation measures, if required. And, of course, the monitoring and care outlined in the report may be exceeded at any time based on the practitioner’s judgment.