Risk factors for inadequate sedation after endotracheal intubation in the pediatric emergency department

• Published in: The American journal of emergency medicine Vol. 56; pp. 15 - 20
• Main Authors: Edmunds, Katherine J., Byczkowski, Terri, Frey, Mary, Boyd, Stephanie, Caruso, Michelle, Zhang, Yin, Kerrey, Benjamin T., Timm, Nathan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2022; Elsevier Limited
• Subjects: Anesthesia; Benzodiazepines; Blood pressure; Check lists; Child; Data collection; Drug administration; Drug dosages; Emergency; Emergency medical care; Emergency Service, Hospital; Etomidate; Fentanyl; Humans; Intensive care; Intubation; Intubation, Intratracheal - adverse effects; Ketamine; Length of stay; Midazolam; Patients; Pediatrics; Risk Factors; Sedatives; Standardization
• ISSN: 0735-6757; 1532-8171; 1532-8171
• DOI: 10.1016/j.ajem.2022.03.002

Berg et al. reported three risk factors for inadequate sedation: the use of a long-acting paralytic, lower systolic blood pressure, and admission to the pediatric intensive care unit [9]. Standardization, in particular with a procedural checklist, has been reported to improve the safety of RSI [10-13]. Since 2012, our academic PED utilized a standardized, checklist-based protocol for RSI and modified RSI performed in the department. The study protocol was reviewed by our Institutional Review Board prior to commencement and was determined exempt. SAS (Version 9.4) was used to conduct the analysis.3 Results 3.1 Enrollment and study subjects During the 5-year study period, we identified 385 eligible patient encounters.