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Paediatric procedural sedation and analgesia in the emergency centre: a description of the fasting status
Background Procedural sedation and analgesia (PSA) is considered a core competency in emergency medicine as patients present to the Emergency Centre (EC) on an unscheduled basis, often complex complaints that necessitate emergent management (1). Previous evidence has consistently shown that procedur...
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| Format: | Thesis |
| Language: | English |
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Division of General Surgery
2023
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| _version_ | 1867613256434057216 |
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| access_status_str | Open Access |
| author | Dunn, Cornelle |
| author2 | Cloete, Philip |
| author_browse | Cloete, Philip Dunn, Cornelle |
| author_facet | Cloete, Philip Dunn, Cornelle |
| author_sort | Dunn, Cornelle |
| collection | Thesis |
| description | Background Procedural sedation and analgesia (PSA) is considered a core competency in emergency medicine as patients present to the Emergency Centre (EC) on an unscheduled basis, often complex complaints that necessitate emergent management (1). Previous evidence has consistently shown that procedural sedation and analgesia(PSA) in the EC in the paediatric population, even the very young, is safe if appropriate monitoring is performed and appropriate medications are used (2–5). The aim of the study was to describe the indications for PSA in the paediatric EC population, the fasting status of paediatric patients undergoing PSA, and the complications observed during PSA in a single Western Cape emergency centre. Methods A retrospective, descriptive study was conducted at Mitchells Plain Hospital, a district-level hospital situated in Mitchells Plain, Cape Town. All paediatric patients younger than 13 years of age who presented to the EC and received PSA during the study period (December 2020 – April 2021) were included in the study. Data was extracted from a standardised PSA form and simple descriptive statistics were used. Results A total of 116 patients (70,7% male) were included: 13 infants (<1 year of age) 48 young children (1-5 years of age) and 55 older children (5-13 years of age). There were only 2 (1,7%) complications documented, both of which were vomiting and did not require admission. The most of patients received ketamine (93,1%). The standardised PSA form was completed in 49,1% of cases. Indications for PSA included burns debridement (11,2%), suturing (17,2%), fracture reduction (23,3%), lumbar punctures (31,9%) and others (27,6%). The indications for PSA varied between the different age groups. Conclusion The study findings are in accordance with previous international literature. Emergency Centre PSA in the paediatric populations did not show an increase in interventions or complications, despite the fasting status (6). Safe, timely PSA with minimal pain and unnecessary suffering can become the norm in Emergency Medicine practice in South Africa. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/37943 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:15.376Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Division of General Surgery |
| publisherStr | Division of General Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/37943 Paediatric procedural sedation and analgesia in the emergency centre: a description of the fasting status Dunn, Cornelle Cloete, Philip Saunders, Colleen Evans, K emergency centre procedural sedation and analgesia paediatrics fasting status Background Procedural sedation and analgesia (PSA) is considered a core competency in emergency medicine as patients present to the Emergency Centre (EC) on an unscheduled basis, often complex complaints that necessitate emergent management (1). Previous evidence has consistently shown that procedural sedation and analgesia(PSA) in the EC in the paediatric population, even the very young, is safe if appropriate monitoring is performed and appropriate medications are used (2–5). The aim of the study was to describe the indications for PSA in the paediatric EC population, the fasting status of paediatric patients undergoing PSA, and the complications observed during PSA in a single Western Cape emergency centre. Methods A retrospective, descriptive study was conducted at Mitchells Plain Hospital, a district-level hospital situated in Mitchells Plain, Cape Town. All paediatric patients younger than 13 years of age who presented to the EC and received PSA during the study period (December 2020 – April 2021) were included in the study. Data was extracted from a standardised PSA form and simple descriptive statistics were used. Results A total of 116 patients (70,7% male) were included: 13 infants (<1 year of age) 48 young children (1-5 years of age) and 55 older children (5-13 years of age). There were only 2 (1,7%) complications documented, both of which were vomiting and did not require admission. The most of patients received ketamine (93,1%). The standardised PSA form was completed in 49,1% of cases. Indications for PSA included burns debridement (11,2%), suturing (17,2%), fracture reduction (23,3%), lumbar punctures (31,9%) and others (27,6%). The indications for PSA varied between the different age groups. Conclusion The study findings are in accordance with previous international literature. Emergency Centre PSA in the paediatric populations did not show an increase in interventions or complications, despite the fasting status (6). Safe, timely PSA with minimal pain and unnecessary suffering can become the norm in Emergency Medicine practice in South Africa. 2023-06-08T12:05:58Z 2023-06-08T12:05:58Z 2023 2023-06-08T12:01:42Z Master Thesis Masters MMed http://hdl.handle.net/11427/37943 eng application/pdf Division of General Surgery Faculty of Health Sciences |
| spellingShingle | emergency centre procedural sedation and analgesia paediatrics fasting status Dunn, Cornelle Paediatric procedural sedation and analgesia in the emergency centre: a description of the fasting status |
| thesis_degree_str | Master's |
| title | Paediatric procedural sedation and analgesia in the emergency centre: a description of the fasting status |
| title_full | Paediatric procedural sedation and analgesia in the emergency centre: a description of the fasting status |
| title_fullStr | Paediatric procedural sedation and analgesia in the emergency centre: a description of the fasting status |
| title_full_unstemmed | Paediatric procedural sedation and analgesia in the emergency centre: a description of the fasting status |
| title_short | Paediatric procedural sedation and analgesia in the emergency centre: a description of the fasting status |
| title_sort | paediatric procedural sedation and analgesia in the emergency centre a description of the fasting status |
| topic | emergency centre procedural sedation and analgesia paediatrics fasting status |
| url | http://hdl.handle.net/11427/37943 |
| work_keys_str_mv | AT dunncornelle paediatricproceduralsedationandanalgesiaintheemergencycentreadescriptionofthefastingstatus |