RT Journal
A1 Langhan ML, Mallory M, Hertzog J, Lowrie L, Cravero J, Pediatric Sedation Research Consortium  
T1 Physiologic monitoring practices during pediatric procedural sedation: A report from the pediatric sedation research consortium
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2012
FD November 1
VO 166
IS 11
SP 990
OP 998
DO 10.1001/archpediatrics.2012.1023
UL http://dx.doi.org/10.1001/archpediatrics.2012.1023
AB Objectives 
                  To describe the frequency of different physiologic monitoring modalities and combinations of modalities used during pediatric procedural sedation; to describe how physiologic monitoring varies among different classes of patients, health care providers (ie, ranging from anesthesiologists to emergency medicine physicians to nurse practitioners), procedures, and sedative medications employed; and to determine the proportion of sedations meeting published guidelines for physiologic monitoring.Design 
                  This was a prospective, observational study from September 1, 2007, through March 31, 2011.Setting 
                  Data were collected in areas outside of the operating room, such as intensive care units, radiology, emergency departments, and clinics.Participants 
                  Thirty-seven institutions comprise the Pediatric Sedation Research Consortium that prospectively collects data on procedural sedation/anesthesia performed outside of the operating room in all children up to age 21 years.Main Outcome Measures 
                  Data including demographics, procedure performed, provider level, adverse events, medications, and physiologic monitors used are entered into a web-based system.Results 
                  Data from 114 855 subjects were collected and analyzed. The frequency of use of each physiologic monitoring modality by health care provider type, medication used, and procedure performed varied significantly. The largest difference in frequency of monitoring use was seen between providers using electrocardiography (13%-95%); the smallest overall differences were seen in monitoring use based on the American Society of Anesthesiologists classifications (1%-10%). Guidelines published by the American Academy of Pediatrics, the American College of Emergency Physicians, and the American Society of Anesthesiologists for nonanesthesiologists were adhered to for 52% of subjects.Conclusions 
                  A large degree of variability exists in the use of physiologic monitoring modalities for pediatric procedural sedation. Differences in monitoring are evident between sedation providers, medications, procedures, and patient types.