Natural Airway Sedation with Pradip Kamat, Part 3
PedsCrit
Sedating a Three-Year-Old for an MRI
Discussion on the challenges of sedating a young child for a 45-minute MRI and the use of propofol as the chosen agent.
Dr. Pradip Kamat is an Associate Professor of Pediatrics at Emory School of Medicine and practicing pediatric intensivist at Children's Healthcare of Atlanta. His clinical and research interests are in procedural sedation and education. We are very excited to have him on our podcast.
Dr. Kamat is also active in PICU open access education. Please check out the PICU Doc On Call podcast co-hosted by Rahul Damania and him at https://picudoconcall.org
During our conversation we discuss:
1. Why this topic is so important for PICU physicians
2. Procedural sedation vs. general anesthesia
3. Conscious sedation???
4. Safety considerations, risk factors and adverse events
5. Patient selection
6. Drug selection
7. Appropriate monitoring
8. Rescue medications.
References and further reading:
Coté CJ, Wilson S; AMERICAN ACADEMY OF PEDIATRICS; AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016. Pediatrics. 2016 Jul;138(1):e20161212. doi: 10.1542/peds.2016-1212. PMID: 27354454.
Emrath ET, Stockwell JA, McCracken CE, Simon HK, Kamat PP. Provision of deep procedural sedation by a pediatric sedation team at a freestanding imaging center. Pediatr Radiol. 2014 Aug;44(8):1020-5. doi: 10.1007/s00247-014-2942-z. Epub 2014 May 24. PMID: 24859263.
Grunwell JR, McCracken C, Fortenberry J, Stockwell J, Kamat P. Risk factors leading to failed procedural sedation in children outside the operating room. Pediatr Emerg Care. 2014 Jun;30(6):381-7. doi: 10.1097/PEC.0000000000000143. PMID: 24849275.
Hooper MC, Kamat PP, Couloures KG. Evaluating the Need for Pediatric Procedural Sedation Training in Pediatric Critical Care Medicine Fellowship. Pediatr Crit Care Med. 2019 Mar;20(3):259-261. doi: 10.1097/PCC.0000000000001809. PMID: 30431555.
Kamat PP, McCracken CE, Simon HK, Stormorken A, Mallory M, Chumpitazi CE, Cravero JP. Trends in Outpatient Procedural Sedation: 2007-2018. Pediatrics. 2020 May;145(5):e20193559. doi: 10.1542/peds.2019-3559. PMID: 32332053.
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Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.
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