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Current practices for paediatric procedural sedation and analgesia in emergency departments: results of a nationwide survey in Korea
  1. Jun Seok Seo1,
  2. Do Kyun Kim2,
  3. Youngjoon Kang3,
  4. Yeon Young Kyong4,
  5. Jin Joo Kim5,
  6. Ji Yun Ahn6,
  7. Ji Sook Lee7,
  8. Hye Young Jang8,
  9. Jin Hee Jung9,
  10. Yoon Hee Choi10,
  11. Seung Baik Han11,
  12. Jin Hee Lee12
  1. 1Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University, Seoul, Republic of Korea
  2. 2Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
  3. 3Department of Emergency Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea
  4. 4Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Gyeonggido, Republic of Korea
  5. 5Department of Emergency Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
  6. 6Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Gyeongggi, Medical Center, Seoul, Republic of Korea
  7. 7Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
  8. 8Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
  9. 9Department of Emergency Medicine, Inje University Seoul Paik Hospital, Seoul Paik Hospital, Inje University, Seoul, Republic of Korea
  10. 10Department of Emergency Medicine, Ewha Womans University Hospital, Seoul, Republic of Korea
  11. 11Department of Emergency Medicine, Inha University College of Medicine, Incheon, Korea
  12. 12Department of Emergency Medicine, Seoul National University Bundang Hospital, Gyeonggido, Republic of Korea
  1. Correspondence to Professor Jin Hee Lee, Department of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumiro, Bundang, Seongnam, Gyeonggido 463-707, Republic of Korea; gienee{at}


Objective Procedural sedation and analgesia (PSA) in children has become a standard tool in emergency settings, but no national PSA guidelines have been developed for the emergency department (ED) in Korea. Therefore, we investigated the practice of PSA and the level of adherence to institutional PSA guidelines in EDs of teaching hospitals.

Methods This study was a cross-sectional, web-based survey. The study subjects were the faculty of EDs from 96 teaching hospitals. The questionnaire was posted on an internet site, and the participants were requested that the questionnaire be answered by email and telephone in May 2009.

Results The questionnaires were completed by 67.7% of the participants. Only 20% of EDs had institutional PSA guidelines, 21.5% of those had discharge criteria and 13.8% of EDs had a discharge instruction form. Residents were administered PSA at 76.9% of EDs. The airway rescue equipment was near the area where PSA was performed in 76.9% of EDs. The most commonly used medication for both diagnostic imaging and painful procedure was oral chloral hydrate (87.7%, 61.5%). In 64.6% of EDs, patients were monitored. In only 21 cases, EDs (50.0%) monitored the patients to recovery after PSA or discharge.

Conclusions Current PSA for paediatric patients have not been appropriately applied in Korea. Unified PSA guidelines were rare in the hospitals surveyed, and many patients were not monitored over an appropriate duration, nor did they receive adequate medications for sedation by the best trained personnel. Therefore, the national PSA guidelines must be developed and implemented as early as possible.

  • Conscious sedation
  • paediatrics
  • surveys
  • intensive care
  • education
  • teaching
  • emergency departments

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  • Competing interests None.

  • Ethics approval Ethics approval was provided by the research ethics board of Seoul National University Bundang Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.