Methods of Rescue/Response

Sedation in pediatric patients can lead to decreased muscle tone and subsequent tissue relaxation and airway narrowing. Thus, sedated children are at risk of respiratory depression, laryngospasm, airway obstruction, apnea, and loss of airway reflexes. Hypotension and cardiopulmonary arrest may also occur, although these complications usually result from failure to recognize and correct respiratory compromise. Despite careful presedation assessment, appropriate medication and dose selection, and appropriate cardiovascular monitoring during the procedure, the risks associated with sedation cannot be eliminated entirely. As it is common for children to pass from the intended level of sedation to deeper levels of sedation, providers should be capable of providing appropriate rescue interventions from one level of sedation deeper than what is intended. Algorithms for response to monitored changes in ventilation and oxygenation are presented that can aid the sedationist in responding effectively to an event, preventing the spiral to a condition producing lasting harm to the patient.

Duke Scholars

Author Corrie Chumpitazi Pediatrics, Emergency Medicine