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- W2617363765 abstract "To the Editor. As an anesthesiologist, a pediatric intensive care physician, but most of all as a Fellow of the American Academy of Pediatrics (AAP), I read with great interest the article by Lowrie et al1 that appeared in the September 1998 issue of Pediatrics electronic pages . I certainly hope that the publication of this article represents an attempt by Pediatrics and the AAP to initiate a controversy and bring to light questionable and unsafe practices in the sedation of children, rather than an endorsement of an institutional practice that violates the standards established by the AAP,2 the American Society of Anesthesiologists,3 and many if not all state laws and regulations governing the scope of practice of nursing.Dr Lowrie describes a “sedation service” in which general anesthesia is induced and maintained using the intravenous anesthetic propofol (Diprivan) by pediatric intensive care physicians. Although the package insert of Diprivan recommends limiting the use of this agent to those with training in general anesthesia, it is not the controversial use of this agent by pediatricians without such training that I wish to criticize in this letter. Rather it is the egregious practice by Lowrie to then send children under propofol anesthesia to remote areas of her hospital attended not by an anesthesiologist, indeed not by any physician, not even by a nurse anesthetist, but rather by unsupervised critical care staff nurses whose training and credentials do not qualify them to administer general anesthetic agents. This practice is inherently unsafe, exposes both Dr Lowrie and her hospital to significant liability, and puts children at significant risk.Dr Lowrie states that “only” 2.5% of cases needed to be cancelled because of complications. This number may at first blush seem small to pediatricians reading this journal, but it must be …" @default.
- W2617363765 created "2017-06-05" @default.
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- W2617363765 date "1999-01-01" @default.
- W2617363765 modified "2023-09-25" @default.
- W2617363765 title "The Pediatric Sedation Unit: A Mechanism for Safe Pediatric Sedation" @default.
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- W2617363765 doi "https://doi.org/10.1542/peds.103.1.198" @default.
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