Sedation is commonly performed in children in the emergency department, however, little is known about adverse events that may occur after discharge. Based on the framework of Leininger, this study was conducted to evaluate adverse effects occurring after discharge in children who had undergone sedation in the emergency department. METHODS: Children receiving pediatric sedation in the emergency department of a pediatric, academic hospital were enrolled, and demographic data, procedure, and sedation regimen were collected during the course of the visit. Parents received a phone call approximately 24 hours after discharge and completed a telephone questionnaire. Parents were asked to report on the presence of the following adverse effects: nausea, vomiting, balance/gait disturbances, lethargy, behavioral changes, headache, sleep disturbances, hallucinations, nightmares, and ear pain. Other adverse events experienced were also recorded. Data were analyzed using descriptive statistics. RESULTS: 547 children were enrolled; 468 (86%) were successfully contacted and completed the phone questionnaire. Mean age=7.0 ± 4.7 years, 58% male, and 52% Caucasian. Sedation agents used included ketamine (62%), nitrous oxide (35%) and others (3%). Sedation was provided for the following procedures: suturing (32%), fracture reduction (29%), abscess I and D (14%), foreign body removal (7%), and others (16%). At least one adverse effect was reported in 42% after discharge from the emergency department. This included nausea (4%), vomiting (7%), balance /gait disturbances (5%), lethargy (12%), behavioral changes (7%), headache (6%), sleep disturbances (4%), hallucinations (2%), nightmares (4%), and ear pain (0.2%). CONCLUSIONS: Children do experience adverse effects from sedation after discharge from the emergency department. Anticipatory guidance about these adverse effects should be given to parents and caregivers prior to discharge.
Session #1193 - Issues Related to the Care of Infants & Children
The 29th Annual MNRS Research Conference (April 1-4, 2005)