PROMOTING ACCESS TO AFRICAN RESEARCH

Southern African Journal of Anaesthesia and Analgesia

The AJOL site is currently undergoing a major upgrade, and there will temporarily be some restrictions to the available functionality.
-- Users will not be able to register or log in during this period.
-- Full text (PDF) downloads of Open Access journal articles will be available as always.
-- Full text (PDF) downloads of subscription based journal articles will NOT be available
We apologise for any inconvenience caused. Please check back soon, as we will revert to usual policy as soon as possible.





Emergency Centre-based paediatric procedural sedation: current practice and challenges in Cape Town

A Burger, P.W. Hodkinson, L.A. Wallis

Abstract


Background: The aims and objectives of this survey of the current practice of doctors working in Emergency Centres (ECs) in the Cape Town metropole was to assess clinical practice and attempt to identify obstacles to the practice of paediatric procedural sedation and analgesia (PPSA). This was considered essential to establish a baseline for quality assurance purposes and improvement.

Methods: After institutional ethics approval, a cross-sectional descriptive study was performed in 25 ECs in both private and government sectors in Cape Town. Specific aspects of PPSA practice were analysed after the anonymous completion of a specifically designed questionnaire, by full-time doctors working at each EC. The doctors’ grade and training, practice preferences, medication and use of monitoring, and any perceived challenges to performing PPSA were assessed.

Results: Sixteen ECs agreed to be part of the study and 62 questionnaires were completed (a 64% response rate). Procedural sedation and analgesia was performed at all the participating ECs, by medical practitioners of varying experience. Doctors’ awareness of unit protocols was inconsistent. Common indications were orthopaedic interventions, radiological investigations and surgical procedures. Medications used were similar in the responding units, but dosages varied. Monitoring was poor compared with local and international standards. The obstacles reported predominantly related to a lack of training and formal protocols.

Conclusions: This study was the first to evaluate the practice of Emergency Centre paediatric procedural sedation and analgesia practice in a South African setting. The lack of a formal system of training and accreditation, for both doctors and facilities, and the need for institutional and nationwide PPSA guidelines were highlighted.

Keywords: Cape Town, paediatric, procedural sedation analgesia




http://dx.doi.org/10.1080/22201181.2018.1541561
AJOL African Journals Online