Faculty Collaboration Database

Pediatric Emergency Medicine Didactics and Simulation (PEMDAS): Pediatric Sedation Complications. MedEdPORTAL 2024;20:11384

Date

02/14/2024

Pubmed ID

38352651

Pubmed Central ID

PMC10861802

DOI

10.15766/mep_2374-8265.11384

Scopus ID

2-s2.0-85185219298 (requires institutional sign-in at Scopus site)

Abstract

INTRODUCTION: Ketamine and propofol are commonly used agents for sedation in the pediatric emergency department (PED). While these medications routinely provide safe sedations, there are side effects providers should be able to recognize and manage. Currently, no pediatric sedation simulations exist in the literature.

METHODS: We created two sedation simulation cases for learners, including pediatric emergency medicine (PEM) fellows, working in the PED: case 1, a 12-year-old male with a shoulder dislocation requiring reduction under propofol sedation, and case 2, a forearm fracture requiring reduction under ketamine sedation. Learner actions included setting up equipment for sedations, dosing medications correctly, and managing complications. Additionally, in case 2, learners assigned an American Society of Anesthesiologists classification and selected the appropriate candidate for PED sedation from amongst three patients. A debrief followed the cases. Next, a didactic presentation reinforced concepts discussed in the debrief. Participants then completed an evaluation of the simulation.

RESULTS: Fifty-eight emergency medicine residents and PEM fellows across four sites at three institutions participated. Participants scored the simulations and the debriefing session on a 5-point Likert scale. Learners rated the scenario as clinically relevant (M = 4.37) and effective at improving their comfort level in caring for critically ill patients (M = 4.36). Learners felt the debrief provided valuable learning (M = 4.40) and was a safe learning environment (M = 4.50).

DISCUSSION: These cases can be utilized as resources for learners in any emergency department and can be tailored to any training background of learner providing sedation.

Author List

Dupont A, Ciener D, Monteilh C, Bharath A, Thomas A, Wolpert K, Pearce J

Author

Jean Pearce MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Emergency Medicine
Humans
Ketamine
Male
Pediatric Emergency Medicine
Propofol
Simulation Training