Current Topics for the Pediatric Sedation Nurse

To Sedate or Not to Sedate: Should that be the question?

By Laura Mitchell, CCLS

This summer, the World Congress of Anesthesiologists met in Hong Kong for their annual conference.  One of the posters presented highlighted a research study conducted at the Université Hospital of Lyon which examined the efficacy of medication (versed) versus distraction (Ipad) in reducing the anxiety of children having surgery. 

For the purposes of this study, the children were divided into two groups, one of which received a pre-medication before anesthesia induction and the other which was given a tablet with age-appropriate games.  The results of the study found that while the anxiety levels of the children and their families were equally reduced in both groups, medical staff perceptions of anesthesia induction and parental satisfaction with the overall experience were better for the distraction group.onlineimage

Pediatric facilities can use studies like this to justify increased budgets, especially when the outcomes reflect both reduced patient anxiety and increased family satisfaction. But, however beneficial studies like these may be to purchase resources, the implications for practice are less clear.

In countless studies, including this one, distraction techniques are offered up as an alternative to sedation medications instead of as a complementary intervention.  By considering sedation and distraction (as well other equally valuable Child Life interventions) as mutually exclusive, we are missing an opportunity to provide the most comprehensive care. 

The scope of services we offer should more accurately be described as a continuum with exclusively non-pharmacologic techniques on one end and exclusively sedation and/or anesthesia interventions on the other. And all along that continuum are opportunities to collaborate to meet the needs of our patients and their families.  Consider how anxiety levels might have been further reduced if some of the patients in this study were offered pre-medication and a chance to play on an  IPad before anesthesia induction. 

Physicians, Nurses and Child Life Specialists can work in partnership to assess needs and develop individualized plans of care.  This multi-disciplinary team approach is already considered a best practice in many pediatric sedation and peri-operative programs.  But there is opportunity for improvement.  By undertaking research studies that examine the effectiveness of a collaborative staffing model, we can generate evidenced based practice which can be used to make our best practice, the new standard of care.

http://journals.lww.com/anesthesia-analgesia/fulltext/2016/09002/Abstract_PR237___Effect_of_Ipad_Tablet_on_Children.230.aspx


Moving Forward: Nursing and Allied Health Committee Update

By Michelle M. Rhoads, MSN, APRN-BC

  • Committee membership – a nursing/allied health committee membership meeting is scheduled for October 4th at 4pm EST and will focus on solicitation of members for initiatives including online education, research, outreach and collaboration opportunities, and updating the website content. If you are a member of the SPS and would like to join this group please email Michelle Rhoads at mrhoads@nemours.org or Lorie Reilly at REILLYL@email.chop.edu.
  • Outreach and collaboration – We continue to collaborate with the American Radiology and Imaging Nurses Association (ARIN) and are currently investigating the possibility of discount membership and conference fees for those that are members of both organizations. Lorie Reilly will be presenting a two part webinar series on Pediatric Sedation in Radiology on October 12th and 26th and Michelle Rhoads and Nancy Crego will be presenting a break-out session, “Pediatric Procedural Sedation in the Medical Imaging Arena” at the March convention to be held in Washington, D. C.

    We have also recently started looking into the possibility of developing a collaborative relationship with the American Society of PeriAnesthesia Nurses. Stay tuned!
  • Education – After a long and arduous process we are finally close to obtaining sedation related web based CEUs, including pharmacology credits, for the SPS website. Many thanks to Lorie Reilly for her hard work and continued perseverance on this project.

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