Impact of young age on outcomes of emergency department procedural sedation.

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Relatively little is known about outcomes of procedural sedation in very young children. Our objective was to examine the association between procedural sedation in young children (≤ 2 years) and the incidence of sedation-related adverse events.This is a secondary analysis of a prospective cohort study of children 0 to 18 years undergoing parenteral procedural sedation in six Canadian pediatric emergency departments (ED). The primary risk factor was age ≤ 2 years. Secondary risk factors were sex, procedure type, pre-procedure and sedation medications. The outcomes examined were: serious adverse events (SAE), significant interventions, oxygen desaturation and vomiting.Of the 6295 patients included, 946 (15%) were ≤2 years. Children 13-24 months comprised 90% of the young age group. Children ≤ 2 years were sedated most commonly for laceration repair (n = 450; 47.6%), while orthopedic reduction was most common in children > 2 (n = 3983; 74.5%). Ketamine was the most common medication in both groups, but was used more frequently in children ≤ 2 years (80.9% vs 58.9%; p 

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Authors: Michael Schlegelmilch, Mark G Roback, Maala Bhatt, Sedation Safety Study Group of Pediatric Emergency Research Canada (PERC), David W Johnson, Ken J Farion, Samina Ali, Suzanne Beno, Andrew Dixon, C Michelle McTimoney, Gabino Travassos, Candice McGahern, Zach Cantor, Eleanor Fitzpatrick, Nadia Dow, Taline Naranian, Gabrielle Allard