Children can reap the benefits of advances in diagnostic and therapeutic modalities; however, these often require procedural sedation. Nationally, pediatric procedural sedation is provided by a wide spectrum of physicians and other practitioners in variable locations for both inpatient and outpatient populations. Serious sedation-related adverse events, which are primarily respiratory in origin, are rare in well-organized sedation service lines occurring in less than 5% of cases. Failure to recognize patients at increased risk for these events, inadequate monitoring, lack of skilled medical personnel, and lack of necessary resuscitation equipment have been associated with worse outcomes.
Providing the necessary education regarding patient pre-screening, analgo-sedative pharmacology, monitoring requirements, pathophysiology of sedation-related adverse events and discharge readiness can be achieved with didactic presentations. However, time constraints often preclude this traditional approach, therefore the availability of online modules with pre and post-module learner assessments provides flexibility in time and pace for team members. The Society for Pediatric Sedation has developed five online modules addressing the elements described above and can be deployed on a variety of platforms. These can be completed with the pre- and post-course written examinations in two hours or less.
However, bringing this knowledge to the bedside and applying it during the crisis of an adverse event requires a different approach. Simulation-based training facilitates team dynamics during a crisis and provides the opportunity to practice resuscitation skills for high stakes low-frequency adverse events.
The Society for Pediatric Sedation has also developed six simulation scenarios that provide sedation teams the opportunity to manage the most common sedation-related adverse events. Each team is comprised of sedation personnel from multiple disciplines such as dentists, physicians, nurses, APRNs, child life specialists. The team is given a patient vignette, determines a sedative regimen to be administered, and once sedation is initiated, the patient then experiences an adverse event. Each scenario targets at least one common adverse event and leads the team through recognition and resuscitation within 10 minutes. Upon scenario completion, team debriefing incorporates lessons learned in an interactive fashion for another 10 to 20 minutes. These simulation scenarios can be easily undertaken in any clinical area performing procedural sedation.
The five online modules and six simulation scenarios comprise the Society for Pediatric Sedation Provider Course®. SPS Platinum institutional members will receive access to the entire course with annual membership. At present, there are several SPS member institutions with developing credentialing processes for sedation providers incorporating the SPS Sedation Provider Course® didactic teaching and simulation components. The Division of Pediatric Critical Care at UH Rainbow Babies & Children’s Hospital has begun to include the online modules and simulation scenarios in training and credentialing pathways for new division faculty and fellows. Their goal is to expand this pathway for all institutional procedural sedation providers.
A key mission of Society for Pediatric Sedation is to promote high quality multi-disciplinary professional education. With the SPS Sedation Provider Course® materials now available for use, every sedation provider and institutional member has access to state-of-the-art pediatric sedation education.