Professional Skills and Competence for Safe and Effective Procedural Sedation in Children: Recommendations Based on a Systematic Review of the Literature
Table 5
(a) Recommended specific additional skills and competence for achieving optimal safety during moderate and deep sedation in children.
Nr
Recommendations
(1)
In order to guarantee optimal levels of safety and effectiveness during a PS involving (a possibility of) moderate-to-deep sedation, the PS must be carried out by a separate professional that is not involved in the actual procedure.
(2)
During a PS involving (a possibility of) moderate or deep sedation and during the subsequent recovery phase, a professional must be present with at least the following additional competence and skills:
(1) The ability to assess and interpret the sedation depth.
(2) The ability to guarantee the necessary monitoring of vital parameters, including capnography, and being able to appraise
and interpret the monitored information.
(3) Having acquired the necessary knowledge during a specialist course and by means of refresher courses and ability to manage
the following techniques at APLS* level:
(3.1) Techniques intended to guarantee an open airway, including skills to manage larynx spasm and to use Laryngeal
Mask Airways.
(3.2) Techniques to administer mask/bag ventilation.
(3.3) The use of antagonists.
(3.4) Heart massage techniques.
PLS: Advanced Pediatric Life Support.
(b) Specific additional skills and competence for achieving optimal safety during mild sedation/anxiolysis in children.
Nr
Recommendations
(1)
During a PS involving mild sedation and during the subsequent recovery phase, a professional must be present with the at least the following additional competence and skills:
(1) The ability to assess and interpret the sedation depth.
(2) The ability to maintain continuous verbal contact with the patient in the absence of any other form of monitoring.
(3) Having acquired the necessary knowledge through a specialist course and by means of refresher courses and the ability to
manage the following techniques at BLS* level:
(3.1) Techniques intended to guarantee an open airway.
(3.2) Techniques to administer mask/bag ventilation.
