DEVELOPMENT OF A SELECTION AND MONITORING PROTOCOL FOR SAFE SEDATION OF CHILDREN

A protocol was developed for children undergoing diagnostic and therap eutic procedures under sedation to try to raise the standards of patie nt selection, preparation, monitoring and management to those of child ren undergoing general anaesthesia. The principles underlying the prot ocol design were that informed consent should be obtained; fasting gui delines as for general anaesthesia should be implemented; contraindica tions to sedation should be actively sought; monitoring should be comm enced from the time of administration of sedation until recovery and s hould be maintained during patient transport; personnel trained in mon itoring and resuscitation of children should have as their sole duty t he monitoring of the sedated child and should not take part in the pro cedure; the minimum monitoring standard should comprise regular assess ments of the level of sedation, oxygen saturation by pulse oximetry, r espiratory rate and pulse rate supplemented by temperature, ECG and bl ood pressure for infants, for prolonged procedures or where verbal con tact with the child is lost.