Journal article
Experience with procedural sedation in a pediatric burn center
Journal of pediatric surgery, Vol.34(6), pp.955-958
1999
DOI: 10.1016/S0022-3468(99)90767-4
PMID: 10392912
Abstract
Background:
Burn care requires daily debridement, dressing changes, and assessment regarding the need for skin grafting. These procedures are painful and may require an operating room environment.
Methods:
The authors reviewed their experience with 912 consecutive procedural sedations (PS) in 220 pediatric burn patients over a 2-year period to identify what influence PS had on patient care. Median patient age was 32 months, and body surface area burn was 7.2% ± 6%. Pharmacological techniques included oral and intravenous medications and N
2O. The authors included all sedations given in the burn treatment area and excluded all treatments given in the intensive care unit or emergency unit.
Results:
PS allowed for early aggressive wound debridement, virtually eliminated the need for operating room debridement (used in only 22 patients), and eliminated patient discomfort and fear often associated with subsequent debridements. Burn wound-related complications occurred in 54 patients and included wound infection (n = 18), graft loss (n = 9), and pneumonia (n = 4). The incidence of PS complications was 7% with the most common problems including decreased arterial saturation (n = 41), emesis (n = 11), and agitation (n = 8). No patient required intubation or transfer to an intensive care unit bed. The average length of stay (LOS) for all patients was 8.7 ± 6.2 days, and 6.2 ± 3.8 days in the 200 patients not admitted to the intensive care unit. This compares favorably with the 9.5-day LOS of patients treated in 1990.
Conclusions:
PS in burn patients allows for early aggressive debridement, decreases the use of the operating room for debridement, and a decrease in length of stay when compared with our previous burn patients. PS has a modest risk of complications, enhances the family's cooperation and satisfaction with health care provided, and should be an integral part of burn care in children.
Details
- Title: Subtitle
- Experience with procedural sedation in a pediatric burn center
- Creators
- Dawn R Ebach - Department of Pediatrics, St Louis Children's Hospital St Louis, Missouri USARobert P Foglia - Department of Pediatrics, St Louis Children's Hospital St Louis, Missouri USAM.Barry Jones - Department of Pediatrics, St Louis Children's Hospital St Louis, Missouri USAJacob C Langer - Department of Pediatrics, St Louis Children's Hospital St Louis, Missouri USAMichael A Skinner - Department of Pediatrics, St Louis Children's Hospital St Louis, Missouri USARobin Moushey - Department of Pediatrics, St Louis Children's Hospital St Louis, Missouri USALisa Meadows - Department of Pediatrics, St Louis Children's Hospital St Louis, Missouri USA
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric surgery, Vol.34(6), pp.955-958
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0022-3468(99)90767-4
- PMID
- 10392912
- ISSN
- 0022-3468
- eISSN
- 1531-5037
- Language
- English
- Date published
- 1999
- Academic Unit
- Stead Family Department of Pediatrics; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984093325802771
Metrics
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