Many brief procedures, such as suture of a minor laceration, may be accomplished with distraction and guided imagery techniques, along with the use of topical/local anesthetics and minimal sedation, if needed.However, longer procedures that require immobility involving children younger than 6 years or those with developmental delay often require an increased depth of sedation to gain control of their behavior.
A child’s ability to control his or her own behavior to cooperate for a procedure depends both on his or her chronologic age and cognitive/emotional development.
Although intended to encourage high-quality patient care, adherence to the recommendations in this document cannot guarantee a specific patient outcome.
However, structured sedation protocols designed to incorporate these safety principles have been widely implemented and shown to reduce morbidity.
Other modalities, such as careful preparation, parental presence, hypnosis, distraction, topical local anesthetics, electronic devices with age-appropriate games or videos, guided imagery, and the techniques advised by child life specialists, may reduce the need for or the needed depth of pharmacologic sedation.
making the concept of rescue essential to safe sedation.