Pediatric Sedation and Analgesia. Jan Bazner-Chandler RN,MSN, CNS, CPNP. PSA. Procedural sedation and analgesia (PSA) refers to the pharmacologic techniques of minimizing or eliminating a child’s pain and anxiety related to invasive or potentially frightening treatments & procedures.
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RN,MSN, CNS, CPNP
Procedural sedation’s goal was to medicate patients safely until they can tolerate unpleasant procedures; i.e, they aren’t really “conscious”.
4. If procedures will be repeated, provide max S&A for 1st procedure
The Joint commission and the American Society of Anesthesiologists (ASA) described the 4 levels of sedation.
Sedation for Cooperation(non-painful but requires the patient to be very still for the duration of the procedure, which may be frightening for the child)
Maintenance dose: 20-40 mg/kg/dose
IV: 0.03-0.05 mg/kg (max dose 10 mg/dose)
IV: 3-4 mg/dose
IV: 0.5 mg-mg/kg
IM: 3-7 mg/kg
(Figure out doses before hand, don’t draw up but be ready)
May repeat dose every 2-3 minutes (max dose is 2 mg/dose.
- “Emergence phenomena”
-adequate respiratory function
-stability of vital signs
-preoperative level of consciousness
-intact protective reflexes
-return of motor/sensory control
-absence of protracted nausea
-adequate state of hydration