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Does your facility have a pediatric sedation team? If not, why not?

Article Excerpt
The 1980s brought many changes in pain management with new research, dispelling the notion that children did not experience pain (Schechter, Blankson, Pachter, Sullivan, & Costa, 1997). Procedures can be both painful and frightening to children, and creating a specialized team to address these concerns is beneficial to both parents and young patients. Many children's hospitals have moved toward a "pain-free" environment following the American Academy of Pediatrics (2001) policy statement that indicated pediatric pain was poorly assessed and under treated. Development of a pediatric sedation team (PST) is essential to the development of a pain-free environment in any children's hospital.

A PST can offer assistance to children requiring procedural sedation. These include procedures such as lumbar puncture, bronchoscopy, echocardiograms, liver and renal biopsies, hematology/oncology procedures, and endoscopies, along with radiology-specific examinations (such as magnetic resonance imaging [MRI], computed axial tomography [CT], and nuclear medicine examinations). A PST is valuable for other potential situations, such as the placement of central venous catheters, peripherally inserted central catheters (PICC lines), hemodialysis catheters, and dressing changes. Although not all of these procedures are considered painful, the environment in which they are performed is potentially frightening--forcing providers to consider how to assist a child in distress through a test or procedure.

Components of a Pediatric Sedation Team

The PST should be directed by a physician educated in airway management techniques, such as a pediatric intensivist or anesthesiologist (Blike & Cravero, 2000). Other members of the team should include RNs, advanced practice RNs, nurse anesthetists, and child life specialists. The team should be multidisciplinary, with pharmacy, case management, and administration involved in protocol development and ongoing quality assurance to ensure the team meets the complete needs of the patients, parents, and facility in a safe and efficient manner (Schechter et al., 1997).

Benefits of a Pediatric Sedation Team

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