Improving procedural sedation and/or analgesia in children : from practice over evidence to practice

Sick children regularly resist medical procedures that are painful and/or stressful, or that require that the child lies still. Therefore Procedural Sedation and/or Analgesia (PSA), known as ‘light sedation’, is often necessary. Recently in the Netherlands serious (sometimes fatal) incidents were reported during PSA in children. This research confirms that PSA in the Netherlands is badly organized: the safety is inadequate and too little use is made of effective techniques. As a result, medical procedures unnecessarily often fail or are uncomfortable. On the basis of literature studies and ethical/legal considerations, the researchers formulated solutions in form of an evidence-based directive. This directive will be implemented from 2012, which will improve the quality of medical care for children.