New guideline on child sedation

21 December 2010

A NEW guideline has been published to ensure young NHS patients are given effective sedation.

For the first time, NICE has issued guidance to improve NHS care and safety standards in England and Wales for sedating infants, children and teenagers. Large numbers of children regularly undergo single or repeated procedures which may require sedation, including MRI scans, biopsies and dental treatment. But this is the first official guidance on how it should be administered.

Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE, said standards of practice in delivering sedation vary greatly across the country. He said: “While the NHS uses numerous sedation techniques there is little guidance on which are most effective and what resources, including staff training, are needed to administer them safely.

“This guideline gives clear recommendations and promotes best practice on the use of sedation techniques to standardise the level of care children, young people and their families can expect from the NHS.” The guideline incorporates a series of recommendations for healthcare professionals including nurses, anaesthetists, doctors and dentists.

Key recommendations include:

• Ensuring that trained healthcare professionals carry out pre-sedation assessments and document the results in the patient's healthcare record
• Offering the child or young person (and their parents or carers) verbal and written information about the proposed sedation technique, the alternatives to sedation and associated risks and benefits
• For moderate and deep sedation, continuously monitor the child or young person, ensuring that the data is clearly documented in the patient's healthcare record
• Healthcare professionals delivering sedation should have documented up-to-date evidence of competency and should ensure they update their knowledge and skills through programmes designed for continuing professional development.

Dr Michael Sury, consultant anaesthetist from Great Ormond Street Hospital in London and chair of the Guideline Development Group, added: “Training for healthcare professionals is particularly important because unsuccessful sedation can be very traumatic for the child and if the dosage of a drug is too great, it can lead to breathing difficulties which may result in brain injury or even death.”

Download the guidance from the NICE website here