PL-1: Sedation/Procedures Rotation
Clinical Director: Keisha Bell, MD
Goals of Rotation:
- Understand prescreening evaluation for pediatric sedation
- Identify stages of sedation
- Develop working knowledge of classes of drugs commonly used in sedation practice
- Familiarize with appropriate equipment set-up and screening
- Learn complications of sedation with appropriate tools for rescue
- Gain skills in intravenous catheter (IV) placement
- Gain skills in various manual procedures, including, but not limited to lumbar puncture, central line placement, arterial puncture and/or line placement
Residents will spend 2 calendar work weeks with the sedation program. In order to accomplish the goals of the rotation, each resident will work as a team with the sedation staff (attending and nurses), spend time the sedation nurses, and be given reading materials (as listed below). They will participate in the direct care of the patients by performing history and physicals, assessing sedation readiness, assisting in the monitoring of the sedated patient, and assessing recovery and discharge eligibility. Provided materials will enhance their learning experience in addition to actually caring for patients undergoing sedation.
In addition, the residents will be taught intravenous catheter placement. They will be summoned, based on availability, to place IVs in pediatric inpatient under the guidance of the nursing staff. The residents will also have available to them procedures which will be supervised by the precepting attending.
The residents, as is routine, will be evaluated by one of the precepting physicians at the end of the rotation.
Supportive Reading Material:
- Cote, C.J., et al., Adverse sedation events in pediatrics: a critical incident analysis of contributing factors. Pediatrics., 2000; 105(4 Pt 1): p. 805-14.
- Cote, C.J. and Stephen Wilson, Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An Update. Pediatrics, 2006; 118: 2587-2602.
- Cravero, J.P. and George Blike, Review of Pediatric Sedation. Anesth Analg, 2004; 99: 1355-64.
- Gorelick, M. et al, Pediatric Sedation Pearls. Clinical Pediatric Emergency Medicine. 2007; 8: 268-278.