Development of a pediatric hospitalist sedation service: Training and implementation
- 31 October 2011
- journal article
- transforming healthcare
- Published by Wiley in Journal of Hospital Medicine
- Vol. 7 (4), 335-339
- https://doi.org/10.1002/jhm.979
Abstract
OBJECTIVE: There is growing demand for safe and effective procedural sedation in pediatric facilities nationally. Currently, these needs are being met by a variety of providers and sedation techniques, including anesthesiologists, pediatric intensivists, emergency medicine physicians, and pediatric hospitalists. There is currently no consensus regarding the training required by non‐anesthesiologists to provide safe sedation. We will outline the training method developed at St. Louis Children's Hospital. METHODS: In 2003, the Division of Pediatric Anesthesia at St. Louis Children's Hospital approached the Division of Pediatric Hospitalist Medicine as a resource to provide pediatric sedation outside of the operating room. Over the last seven years, Pediatric Hospitalist Sedation services have evolved into a three‐tiered system of sedation providers. The first tier provides sedation services in the emergency unit (EU) and the Center for After Hours Referral for Emergency Services (CARES). The second tier provides sedation throughout the hospital including the EU, CARES, inpatient units, Ambulatory Procedure Center (APC), and Pediatric Acute Wound Service (PAWS); it also provides night/weekend sedation call for urgent needs. The third tier provides sedation in all of the second‐tier locations, as well as utilizing propofol in the APC. RESULTS: This training program has resulted in a successful pediatric hospitalist sedation service. Based on fiscal year 2009 billing data, the division performed 2,471 sedations. We currently have 43 hospitalists providing Tier‐One sedation, 18 Tier‐Two providers, and six Tier‐Three providers. CONCLUSIONS: A pediatric hospitalist sedation service with proper training and oversight can successfully augment sedation provided by anesthesiologists. Journal of Hospital Medicine 2012;. © 2011 Society of Hospital MedicineKeywords
This publication has 17 references indexed in Scilit:
- Risk and safety of pediatric sedation/anesthesia for procedures outside the operating roomCurrent Opinion In Anesthesiology, 2009
- Safety of Propofol Sedation for Pediatric Outpatient ProceduresClinical Pediatrics, 2009
- Pediatric sedation/anesthesia outside the operating roomCurrent Opinion In Anesthesiology, 2008
- High dose dexmedetomidine as the sole sedative for pediatric MRIPediatric Anesthesia, 2008
- Propofol Sedation: Intensivists' Experience With 7304 Cases in a Children's HospitalPEDIATRICS, 2007
- Successful Implementation of a Radiology Sedation Service Staffed Exclusively by Pediatric Emergency PhysiciansPEDIATRICS, 2006
- Procedural Sedation in the Pediatric PatientAnesthesiology Clinics of North America, 2005
- Pediatric sedation in North American children's hospitals: a survey of anesthesia providersPediatric Anesthesia, 2005
- Pediatric sedation: can it be safely performed by non-anesthesiologists?Current Opinion In Anesthesiology, 2002
- Development of a nurse-led sedation service for paediatric magnetic resonance imagingThe Lancet, 1999