Episode 76 Pediatric Procedural Sedation

Emergency Medicine Cases

Dr. Anton Helman

Science, Courses, Medicine, Health & Fitness, Education

4.7 • 602 Ratings

🗓️ 9 February 2016

⏱️ 60 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this EM Cases episode on Pediatric Procedural Sedation with Dr. Amy Drendel, a world leader in pediatric pain management and procedural sedation research, we discuss how best to manage pain and anxiety in three situations in the ED: the child with a painful fracture, the child who requires imaging in the radiology department and the child who requires a lumbar puncture. Without a solid understanding and knowledge of the various options available to you for high quality procedural sedation, you inevitably get left with a screaming suffering child, upset and angry parents and endless frustration doe you. It can make or break an ED shift. With finesse and expertise, Dr. Drendel answers such questions as: What are the risk factors for a failed Pediatric Procedural Sedation? Why is IV Ketamine preferred over IM Ketamine? In what situations is Nitrous Oxide an ideal sedative? How long does a child need to be observed in the ED after Procedural Sedation? Do children need to have fasted before procedural sedation? What is the anxiolytic of choice for children requiring a CT scan? and many more...

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases Podcast.
0:05.8	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine
0:10.5	from EMC Studios in Toronto.
0:27.8	In episode 67 on pediatric pain management with Dr. Samina Ali and Dr. Anthony Crocko,
0:34.1	we discussed the use of triage-initiated pain protocols, intranasal fentanyl, intranasal ketamine,
0:39.0	the dangers of codeine, skin analgesics for venipuncture, and a lot more.
0:43.2	But we didn't get around to talking about procedural sedation for things like fracture reduction and complicated laceration repair. Very common presentations that I see at North York
0:49.7	General on almost every shift. In that episode, we also drove home five key points that are eloquently summed up by our guest
0:59.0	expert on this episode, Dr. Amy Drendel, in five simple clinical pearls.
1:05.4	And here they are.
1:07.0	Number one.
1:08.8	Reassessment is the key to effective pain treatment in the ED.
1:12.6	Number two.
1:15.6	Ibuprofen is very effective for treating pediatric pain, but some kids will need more than ibuprofen for optimal pain treatment.
1:23.6	Number three.
1:25.6	Proper pain treatment and utilization of sedation when needed will result in increased procedural success, reduce pain experience during fracture procedures, and patient family satisfaction.
1:38.3	It's worth taking the time and the risks are low.
1:41.3	Number four. Treatment of pain can actually help you make the right diagnosis.
1:49.8	Number five.
1:51.8	Talk to parents about a pain treatment plan for home.
1:54.7	Most kids have pain after discharge from the ED, but most parents do not treat the pain
1:59.2	at home.
	...

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