Procedural sedation at Sidra Medicine, Greenfield start lead by the emergency department team

Joint Event on 7^th Global Experts Meeting on Nursing and Nursing Practice & 4^th World Congress on Neonatology and Perinatology

December 09-10, 2019 | Barcelona, Spain

Ibtihal Abdelgadir, Colin Powell, Gokul Erumbala, Lisabeth Goldsworthy, Berenice Traub, Barbra Blackie, Samir Deiratany and Khalid Al-Ansari

Sidra Medicine, Qatar

Posters & Accepted Abstracts: J Nurs Res Pract

Abstract :

Introduction: Procedural sedation is a well-established process that can be safely delivered in the pediatric emergency departments (PED) for the management of minor injuries and procedures. It involves a drug induced alteration of consciousness during which minimal interventions are required to maintain a patent airway, spontaneous ventilation and cardiovascular function. Procedural sedation training and credentialing for all responsible staff started 6 months in advance of the June 2018 opening of a newly created department.

Method: Training: Physicians are required to complete the credentialing and privileging process defined by the hospital procedural sedation committee. This comprises: completion of the hospital procedural sedation course, which includes formative assessment of candidates managing simulated scenarios, holding and maintaining a current advanced pediatric life support course certificate and 10 observed sedations conducted with an experienced provider. Credentialing needs to be repeated every two years. Nursing staff also have to complete a training package. Experience: Detailed records of department’s procedural sedation cases between August 2018 and May 2019 have been reviewed using a standardized proforma. Process, complications and outcomes have been recorded.

Results: A total of 133 clinicians (41 physicians and 92 nurses) have successfully completed the course. Twenty five clinicians have fulfilled the privileging process and are now providing procedural sedation independently. A total of 62 nurses have completed their required competency assessment. A total of 815 patients have undergone procedural sedation over the 10 months. Indications for sedation were mainly for laceration repair, closed fracture reductions and abscess drainage. Four incidents occurred; an accidental ketamine overdose, laryngeal spasm, hypotension and vomiting. All were managed appropriately and no harm occurred.

Conclusion: The PED at Sidra Medicine has successfully launched a sedation training program and competency assessment process. It has now established a skilled team which provides safe procedural sedation.