Development of a selection and monitoring protocol for safe sedation of children.

A protocol was developed for children undergoing diagnostic and therapeutic procedures under sedation to try to raise the standards of patient selection, preparation, monitoring and management to those of children undergoing general anaesthesia. The principles underlying the protocol design were that informed consent should be obtained; fasting guidelines as for general anaesthesia should be implemented; contraindications to sedation should be actively sought; monitoring should be commenced from the time of administration of sedation until recovery and should be maintained during patient transport; personnel trained in monitoring and resuscitation of children should have as their sole duty the monitoring of the sedated child and should not take part in the procedure; the minimum monitoring standard should comprise regular assessments of the level of sedation, oxygen saturation by pulse oximetry, respiratory rate and pulse rate supplemented by temperature, ECG and blood pressure for infants, for prolonged procedures or where verbal contact with the child is lost.