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Background <p>We investigated the use of mild procedural sedation/analgesia in children at community hospitals to describe current practices and identify challenges to its effective implementation.</p> Methods <p>Cross-sectional survey among all medical and nursing staff of the Paediatric, Emergency, Anesthesiology and Surgical Units of four secondary care hospitals in Italy, in the years 2021–2022.</p> Results <p>The response rate was 80% (range across centers 57%-100%); 346 complete questionnaires were analyzed (52.6% physicians; 47.4% nurses). Overall, procedural pain in children was considered a relevant topic by 90.8% of staff. Procedural sedation/analgesia was considered helpful for procedural success (97.4%) and for improving children’s experience of pain/anxiety (98.6%). However, 47.7% were not satisfied with the management of procedural pain/anxiety at their workplace and 56.9% reported a lack of adequate knowledge. In fact, only 22.8% demonstrated adequate knowledge on fasting times and 39.6% on correct patient monitoring during procedural sedation. From a pharmacological perspective, midazolam was the most accessible (80.9%) and used (58.7%) medication, while intranasal fentanyl and nitrous oxide were less available (15.3% and 2.9% respectively) and used (7.2% and 2.6% respectively). Procedural sedation was generally practiced by anesthesiologists (65.9%). Overall, 91.9% of respondents performed/participated in &lt; 4 pediatric sedations per month. For 64.3% lack of training represented the greatest barrier to pediatric sedation/analgesia implementation.</p> Conclusions <p>Despite staff awareness about the importance of pediatric procedural sedation/analgesia, lack of specific knowledge and training, as well as limited availability of sedative/analgesic medications represent current challenges to procedural sedation implementation in community hospitals without a pediatric emergency room.</p>

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Pediatric procedural sedation and analgesia in the emergency setting in community hospitals in Italy: current status and challenges

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月24日

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  • Martina Langeli,
  • Flavia Predieri,
  • Michele Di Toma,
  • Angelo Campanozzi,
  • Simone Rugolotto,
  • Francesco Torcetta,
  • Alessandro Mazza,
  • Tiziana Zangardi,
  • Marco Bazo,
  • Carla Pizzini,
  • Silvia Bressan

摘要

Background

We investigated the use of mild procedural sedation/analgesia in children at community hospitals to describe current practices and identify challenges to its effective implementation.

Methods

Cross-sectional survey among all medical and nursing staff of the Paediatric, Emergency, Anesthesiology and Surgical Units of four secondary care hospitals in Italy, in the years 2021–2022.

Results

The response rate was 80% (range across centers 57%-100%); 346 complete questionnaires were analyzed (52.6% physicians; 47.4% nurses). Overall, procedural pain in children was considered a relevant topic by 90.8% of staff. Procedural sedation/analgesia was considered helpful for procedural success (97.4%) and for improving children’s experience of pain/anxiety (98.6%). However, 47.7% were not satisfied with the management of procedural pain/anxiety at their workplace and 56.9% reported a lack of adequate knowledge. In fact, only 22.8% demonstrated adequate knowledge on fasting times and 39.6% on correct patient monitoring during procedural sedation. From a pharmacological perspective, midazolam was the most accessible (80.9%) and used (58.7%) medication, while intranasal fentanyl and nitrous oxide were less available (15.3% and 2.9% respectively) and used (7.2% and 2.6% respectively). Procedural sedation was generally practiced by anesthesiologists (65.9%). Overall, 91.9% of respondents performed/participated in < 4 pediatric sedations per month. For 64.3% lack of training represented the greatest barrier to pediatric sedation/analgesia implementation.

Conclusions

Despite staff awareness about the importance of pediatric procedural sedation/analgesia, lack of specific knowledge and training, as well as limited availability of sedative/analgesic medications represent current challenges to procedural sedation implementation in community hospitals without a pediatric emergency room.