Co-endorsed sedation guidelines issued

American Academy of Pediatric Dentistry and the American Academy of Pediatrics form joint recommendations about the monitoring and management of pediatric patients during and after sedation.

CHICAGO--The American Academy of Pediatric Dentistry and the American Academy of Pediatrics have announced joint recommendations for all medical and dental practitioners regarding the monitoring and management of pediatric patients during and after sedation.

This partnership reinforces a standardized approach to pediatric sedation procedures across the health professions. The new guidelines follow definitions of sedation categories and expected physiological responses currently used by the Joint Commission of Accreditation of Healthcare Organizations and the American Society of Anesthesiologists.

"This partnership with the AAP to provide extensive, updated sedation guidelines is a monumental step toward ensuring that all children who undergo a medical or dental procedure receive the safest, most effective treatment," said Dr. Phil Hunke, President of the American Academy of Pediatric Dentistry. "Practicing in a manner consistent with the guidelines will benefit the entire pediatric medical community."

The need for guidelines across the medical spectrum is a result from the increasing trend in outpatient procedures that involve sedation become more common outside of the hospital environment.

The guidelines recommend:

*No administration of sedating medications without the safety net of medical supervision by a licensed practitioner in medicine, surgery or dentistry.

*Careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications.

*Appropriate fasting for elective procedures and a balance between depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure.

*A clear understanding of the pharmacokinetic and pharmacodynamic effects of the medications used for sedation as well as an appreciation for drug interactions.

*Appropriate training and skills in airway management to allow rescue of the patient, should there be an adverse response.

*Age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents.

*Sufficient numbers of staff to both carry out the procedure and monitor the patient during and after the procedure.

*Appropriate physiologic monitoring during and after the procedure.

*A properly equipped and staffed recovery area, recovery to presedation level of consciousness before discharge from medical supervision, and appropriate discharge instructions.

For more information or to view the guidelines, visit either the AAP's Web site at www.aap.org or the AAPD's Web site at www.aapd.org.

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