In our January 25,
2011 Patient Safety Tip of the Week Procedural
Sedation in Children we mentioned the Pediatric Sedation Research
Consortium (PSRC). Thats a large collaborative group of institutions doing
sedation for procedures in pediatrics who have come together to share data and
foster research. They now have accumulated data on over 100,000 children
undergoing sedation for procedures outside the operating room (including procedures
such as MRI scans, lumbar punctures, bone marrow biopsies, endoscopies, etc.).
While the overall
rates of serious adverse events have been relatively low, a new study from the
PSRC (Langhan
2012) shows wide variation in compliance with monitoring guidelines during
procedural sedation. Guidelines published by the American Academy of
Pediatrics, American College of Emergency Physicians, and American Society of
Anesthesiologists were adhered to in only 52% of procedures.
They noted
tremendous variability between specialties in the monitoring used. Of
particular concern, radiologists used pulse oximetry in only a third of cases
and did not use any monitoring in about 40% of cases.
Weve done numerous
articles (see the list at the end of this article) on radiology as a high risk
area for a variety of reasons, many of which are not directly related to
radiology. But procedural sedation is one of the areas directly related to radiology
personnel. Whats compliance with monitoring like in your radiology department?
We hope youll look
at our extensive discussion on procedural sedation in our January 25, 2011
Patient Safety Tip of the Week Procedural
Sedation in Children.
Some of our prior columns on procedural sedation:
·
May 25, 2010 Propofol
Issues
·
August 2012 Sedation
Costs for Pediatric MRI
· January 25, 2011 Procedural Sedation in Children
· May 2011 Update on Pediatric Procedural Sedation
· August 2011 NEJM Video on Conscious Sedation for Minor Procedures in Adults
· October 2011 The Procedural Sedation Debate Rages On
· April 2012 Problems with Ketofol
Some of our prior columns on patient safety issues in the radiology suite:
· October 16, 2007 Radiology as a Site at High-Risk for Medication Errors
· September 16, 2008 More on Radiology as a High Risk Area
·
October 7, 2008 Lessons
from Falls....from Rehab Medicine
·
January 2010 Falls
in the Radiology Suite
·
August 2010 Sedation
Costs for Pediatric MRI
·
January 25,
2011 Procedural
Sedation in Children
·
February 19, 2008 MRI
Safety
References:
Langhan ML, Mallory M,
Hertzog J, Lowrie L, Cravero J for the Pediatric Sedation Research Consortium.
Physiologic Monitoring Practices During Pediatric Procedural Sedation. A Report
From the Pediatric Sedation Research Consortium. Arch Pediatr Adolesc Med 2012;
Published online September 10, 2012
http://archpedi.jamanetwork.com/article.aspx?articleid=1357757
http://www.patientsafetysolutions.com/