Guidelines for Sedation:
1)American Academy of Pediatrics Committee on Drugs. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatrics 1992;89:1110-1115.
2)AAP Policy Statement: Alternative Routes of Drug Administration – Advantages and Disadvantages. Committee on Drugs. Pediatrics. July 1997.
Comment: This statement reviewed a variety of alternative dosing routes including transdermal, transmucosal, and rectal. It is included in this review of the literature because most of the drugs that are described are in some way applicable to pain or sedation management for children.
3)American Society of Anesthesiologists. Standards: Continuum of Depth of Sedation/Definition of General Anesthesia and Levels of Sedation/analgesia.
4)AAP Statement: Evaluation and Preparation of Pediatric Patients Undergoing Anesthesia. Section on Anesthesiology. September 1996
Comment: Statement reviewed the medical issues of concern to anesthesiologists and surgeons concerning the evaluation and preparation of children in the preoperative period. Guidelines for general pediatricians are also included. The statement is relevant to our current search because it addresses issues concerning anesthesia and sedation that are important for practitioners involved in delivering this care in emergency departments.
5)American Academy of Pediatrics Committee on Drugs. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatrics 1992;89:1110-1115.
6)American College of Emergency Physicians: Clinical policy for procedural sedation and analgesia in the emergency department. Ann Emerg Med May 1998;31 663-677.
7)Pediatric Committee of the American College of Emergency Physicians. Pediatric analgesia and sedation. Annals Emergency Medicine February 1994, 23: 237-250.
Comment: This paper reviews the agents to be used and monitoring procedures for painful procedures performed in the Emergency Department – from the perspective of emergency medicine physicians. It also discusses discharge criteria after sedation is given.
8)National Institutes of Health. Consensus conference – anesthesia and sedation in the dental office JAMA. 1985;254:1073-1076.
9)American Academy of Pediatric Dentistry. Guidelines for the elective use of pharmacologic conscious sedation and deep sedation in pediatric dental patients. Pediatr Dent. 1997;19:48-52.
10)American Dental Society of Anesthesiologists. A. D. S. A. guidelines of intra-operative monitoring of patients undergoing conscious sedation, deep sedation and general anesthesia. J Conn State Dent Assoc. 1988;62:210-211.
11)American Academy of Pediatric Dentistry. Guidelines for the elective use of conscious sedation, deep sedation, and general anesthesia in pediatric patients. ASDC J Dent Child. 1986;53:21-22.
12)American Society of Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 1996;84:459-471.
13)Joint Commission on Accreditation of Healthcare Organizations. Care of Patients: Examples of Compliance. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations; 1999:87-91.
14)Nelson MD Jr. Guidelines for the monitoring and care of children during and after sedation for imaging studies. AJR. 1994;581-582.
15)Macpherson CF, Lundblad LA: Conscious sedation of pediatric oncology patients for painful procedures: development and implementation of a clinical practice protocol. Journal of Pediatric Oncology Nursing. 14(1): 33-42: 1997 Jan.
Comment: Protocol is included. A review of the literature is also included along with 16 references.
16)AAP Statement: Prevention and Management of Pain and Stress in the Neonate. Fetus and Newborn Committee. Feb 2000.
Comment: Statement reviewed issues surrounding pain control in newborns. A review of the physiologic implications of pain and recommended effective and safe interventions for pain and stress management are included.
17)Innes G. Murphy M. Nijssen-Jordan C. Ducharme J. Drummond A. Procedural sedationand analgesia in the emergency department. Canadian Consensus Guidelines. Journal of Emergency Medicine. 17(1):145-56, 1999 Jan-Feb.
Comment: These guidelines come from the Canadian Association of Emergency Physicians (CAEP) who determined the need to establish guidelines for procedural sedation in the ED for providers in their country. A subcommittee reviewed existing literature, determined levels of evidence, and developed the document, which evolved based on feedback from the CAS and CAEP Standards Committees. These are generally well though out guidelines that discuss the goals, definitions, and principles of ED sedation, and make recommendations for pre-sedation preparation, patient fasting, physician skills, equipment and monitoring requirements, and post-sedation care. The guidelines are intended for non-anesthesiologists but serve as a good reference for anyone who provides sedation for children. Joseph Cravero MD
18)Morton NS et al. Development of a selection and monitoring protocol for safe sedation of children. Paediatr Anaesth. 1998;8(1):65-8.
19)Pediatric Dentistry July/August 1993 Volume 15, number 4 Guidelines for the effective use of pharmacologic conscious sedation and deep sedation in pediatric dental patients.
Comment: This document reviews the use of sedation medications and monitoring for dental practitioners. Its contents were not developed with the sanction of the AAP although an earlier version (1985) did have the AAP seal of approval.