Validation of the Pediatric Sedation State Scale
Joseph P. Cravero,Nissa Askins,Patcharee Sriswasdi,Daniel S. Tsze,David Zurakowski,Sean Sinnott +5 more
TLDR
The Pediatric Sedation State Scale is a 6-point scale that is a valid measure of the effectiveness and quality of procedural sedation in children within the limits of the testing method used in this study.Abstract:
OBJECTIVES: Development and validation of the Pediatric Sedation State Scale (PSSS) is intended to specifically meet the needs of pediatric procedural sedation providers to measure effectiveness and quality of care. METHODS: The PSSS content was developed through Delphi methods utilizing leading pediatric sedation experts and published guidelines on procedural sedation in children. Video clips were created and presented to study participants, who graded the state of patients during procedures by using the PSSS to evaluate inter- and intrarater reliability by determining the intraclass correlation coefficient. We also compared the PSSS to the Observational Scale of Behavioral Distress–revised during 4 clinically relevant phases of a laceration repair procedure. RESULTS: Six sedation states were defined for the PSSS. Each state was assigned a numerical value with higher numbers for increasing activity states. We included behaviors associated with adequate and inadequate sedation and adverse events associated with excessive sedation. Analysis of interrater and intrarater reliability revealed an intraclass correlation coefficient of 0.994 (95% confidence interval: 0.986–0.998) and 0.986 (95% confidence interval: 0.970–0.995), respectively. Criterion validity was confirmed with respect to the Observational Scale of Behavioral Distress–revised (Spearman r = 0.96). Construct validity was indicated by significant differences in PSSS scores ( P CONCLUSIONS: The PSSS is a 6-point scale that is a valid measure of the effectiveness and quality of procedural sedation in children within the limits of the testing method used in this study.read more
Citations
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Unscheduled Procedural Sedation: A Multidisciplinary Consensus Practice Guideline
Steven M. Green,Mark G. Roback,Baruch Krauss,James R. Miner,Sandra M. Schneider,Paul D. Kivela,Lewis S. Nelson,Corrie E. Chumpitazi,John D. Fisher,Dan Gesek,Benjamin F. Jackson,Pradip Kamat,Terry Kowalenko,Brandon Lewis,Michele Papo,Don Phillips,Sonny Ruff,Daniel Runde,Thomas Tobin,Nathan Vafaie,John J. Vargo,Eric M. Walser,Donald M. Yealy,Robert E. O'Connor +23 more
TL;DR: This document outlines the underlying background and rationale, and issues relating to staffing, practice, and quality improvement relating to unscheduled procedural sedation regardless of location or patient age.
Journal ArticleDOI
Pain and Sedation Management: 2018 Update for the Rogers' Textbook of Pediatric Intensive Care.
TL;DR: Recent research into pediatric pain and sedation management has focused on optimizing the choice of sedative medications, in particular by increasing the use and understanding of nonopioid and nonbenzodiazepine options such as ketamine and alpha-2 agonists.
Journal ArticleDOI
Sedation and Analgesia During Pediatric Burn Dressing Change: A Survey of American Burn Association Centers.
Jennifer K Hansen,Jordan Voss,Hammad A. Ganatra,Travis Langner,Prabhakar Chalise,Shaun Stokes,Dhaval Bhavsar,Anthony L. Kovac +7 more
TL;DR: A collaborative effort among institutions is needed to formulate practice guidelines for sedation during burn dressing changes, as commonly used medications including opioids, benzodiazepines, ketamine, oral opioids, and topical lidocaine were used frequently.
Journal ArticleDOI
Safety and Efficacy of the Combination of Propofol and Ketamine for Procedural Sedation/Anesthesia in the Pediatric Population: A Systematic Review and Meta-analysis
TL;DR: It is concluded that the use of propofol and ketamine may result in a slight-to-small reduction in the risk of hypotension, bradycardia, and apnea, and a slight increase in therisk of tachy Cardia, hypertension, and other respiratory adverse events, such as cough or laryngospasm.
Journal ArticleDOI
Non-operating room anaesthesia in children
TL;DR: The article outlines various safety guidelines, sedation techniques, drugs used for sedation, environmental concerns, procedure-specific risks, and complications associated with NORA in children.
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Validity and reliability of the Observer's Assessment of Alertness/Sedation Scale: study with intravenous midazolam.
Doris A. Chernik,Dennis Gillings,Harriet Laine,Judith Hendler,Jonathan M. Silver,Arnold B. Davidson,Elias M. Schwam,Judith L. Siegel +7 more
TL;DR: The Observer's Assessment of Alertness/Sedation (OAA/S) Scale was developed to measure the level of alertness in subjects who are sedated and was reliable and valid as measured by high correlation between the two raters and high correlations between the OAA/s Scale and two of the three standard tests used in this study.