Page 104 - HA Convention 2016 [Full Version]

HOSPITAL AUTHORITY CONVENTION 2016 Masterclasses

M3.3 Sedation Services in the Hospital Authority 13:15 Room 221

Paediatric Sedation: Keep it Safe!
Hui T
Department of Anaesthesiology, Queen Mary Hospital, Hong Kong

Sedation is required to facilitate unpleasant diagnostic or minor surgical procedures. Advances in medicine has led to an
increasing number of painful or distressing diagnostic or therapeutic procedures. In adults, many of these procedures can be
undertaken with local anaesthesia and reassurance. Very often this is not possible in children because the procedures are
too frightening or painful. In particular, children less than five years of age or young people with behavioural problem require
sedation for almost all procedures.

Procedural sedation is not without risks. It can result in significant morbidity and mortality if not managed well. Many
patient safety concerns apply to the sedation procedure. These include medications delivered, staff competence,
adequate monitoring and emergency equipment, pre-sedation patient preparation, post-sedation patient education, and
documentation.

In this presentation, measures to enhance safety in paediatric sedation will be discussed.

Tuesday, 3 May

M3.4 Sedation Services in the Hospital Authority 13:15 Room 221

Safe Sedation Training for Non-anaesthesiologists
Chen PP
Anaesthesia and Operating Services, Alice Ho Miu Ling Nethersole Hospital, Hong Kong

Sedation for diagnostic and therapeutic procedures is commonly performed as an outpatient procedure by non-
anaesthesiologist. Procedural sedation is associated with an inherent risk of adverse events that may occur suddenly and
unexpectedly. Traditional practices underestimate the difficulty of sedation process and risk of complication, and hence
the need for adequate training. It is essential that procedural sedation should only be undertaken by trained and qualified
healthcare staff.

In Hong Kong, procedural sedation is often provided by doctor who is responsible for the procedure itself, with facilities
that may not be equipped with managing serious clinical adverse events. Formal training for doctors and healthcare
assistants may also be inadequate. Adverse complications of sedation process were once highlighted in the mass media.
In 2010, the Hong Kong Academy of Medicine (HKAM) published a guideline on procedural sedation which specified the
minimum requirements and standards for facility and healthcare staff involved in procedural sedation. Proceduralists and
administrators began to take note of the need to enhance both facility and training to ensure safe sedation.

A course entitled “Enhancing Safety in Sedation” was developed by the Hong Kong College of Anaesthesiologists in 2010
to provide formal training in sedation safety for doctors and nurses, following the publication of the HKAM guideline. Later a
separate course for paediatric sedation was introduced in 2013. This presentation will review the essential aspects of these
sedation courses and recommend future strategies to consolidate the training for safe procedural sedation.

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