PDF(Pubmed)
Abstract：
UNASSIGNED: Little is known about the practice of pediatric procedural sedation in Africa, despite being incredibly useful to the emergency care of children. This study describes the clinical experiences of African medical providers who use pediatric procedural sedation, including clinical indications, medications, adverse events, training, clinical guideline use, and comfort level. The goals of this study are to describe pediatric sedation practices in resource-limited settings in Africa and identify potential barriers to the provision of safe pediatric sedation.
UNASSIGNED: This mixed methods study describes the pediatric procedural sedation practices of African providers using semi-structured interviews. Purposive sampling was used to identify key informants working in African resource-limited settings across a broad geographic, economic, and professional range. Quantitative data about provider background and sedation practices were collected concurrently with qualitative data about perceived barriers to pediatric procedural sedation and suggestions to improve the practice of pediatric sedation in their settings. All interviews were transcribed, coded, and analyzed for major themes.
UNASSIGNED: Thirty-eight key informants participated, representing 19 countries and the specialties of Anesthesia, Surgery, Pediatrics, Critical Care, Emergency Medicine, and General Practice. The most common indication for pediatric sedation was imaging (42%), the most common medication used was ketamine (92%), and hypoxia was the most common adverse event (61%). Despite 92% of key informants stating that pediatric procedural sedation was critical to their practice, only half reported feeling adequately trained. The three major qualitative themes regarding barriers to safe pediatric sedation in their settings were: lack of resources, lack of education, and lack of standardization across sites and providers.
UNASSIGNED: The results of this study suggest that training specialized pediatric sedation teams, creating portable \"pediatric sedation kits,\" and producing locally relevant pediatric sedation guidelines may help reduce current barriers to the provision of safe pediatric sedation in resource-limited African settings.
UNASSIGNED: This mixed methods study describes the pediatric procedural sedation practices of African providers using semi-structured interviews. Purposive sampling was used to identify key informants working in African resource-limited settings across a broad geographic, economic, and professional range. Quantitative data about provider background and sedation practices were collected concurrently with qualitative data about perceived barriers to pediatric procedural sedation and suggestions to improve the practice of pediatric sedation in their settings. All interviews were transcribed, coded, and analyzed for major themes.
UNASSIGNED: Thirty-eight key informants participated, representing 19 countries and the specialties of Anesthesia, Surgery, Pediatrics, Critical Care, Emergency Medicine, and General Practice. The most common indication for pediatric sedation was imaging (42%), the most common medication used was ketamine (92%), and hypoxia was the most common adverse event (61%). Despite 92% of key informants stating that pediatric procedural sedation was critical to their practice, only half reported feeling adequately trained. The three major qualitative themes regarding barriers to safe pediatric sedation in their settings were: lack of resources, lack of education, and lack of standardization across sites and providers.
UNASSIGNED: The results of this study suggest that training specialized pediatric sedation teams, creating portable \"pediatric sedation kits,\" and producing locally relevant pediatric sedation guidelines may help reduce current barriers to the provision of safe pediatric sedation in resource-limited African settings.
摘要：
■对非洲儿科程序镇静的实践知之甚少，尽管对儿童的紧急护理非常有用。这项研究描述了使用儿科程序镇静的非洲医疗提供者的临床经验，包括临床适应症，药物,不良事件,培训,临床指南使用，和舒适度。这项研究的目的是描述非洲资源有限的环境中的儿科镇静实践，并确定提供安全儿科镇静的潜在障碍。
■这项混合方法研究使用半结构化访谈描述了非洲提供者的儿科程序镇静实践。目的抽样用于确定在广泛地理区域的非洲资源有限环境中工作的关键线人，经济,和专业范围。同时收集有关提供者背景和镇静实践的定量数据，以及有关儿科程序镇静障碍的定性数据，以及改善其设置中儿科镇静实践的建议。所有采访都是转录的，编码,并分析了主要主题。
■38名主要线人参加了，代表19个国家和麻醉专业，手术,儿科,重症监护,急诊医学,和一般实践。儿科镇静最常见的指征是影像学（42%），最常见的药物是氯胺酮（92％），缺氧是最常见的不良事件（61%）。尽管92%的关键线人表示儿科程序镇静对他们的实践至关重要，只有一半的人表示感觉受到了充分的训练。关于安全儿科镇静障碍的三个主要定性主题是：缺乏资源，缺乏教育,以及缺乏跨站点和提供商的标准化。
■这项研究的结果表明，培训专门的儿科镇静团队，创建便携式“儿科镇静试剂盒，并制定当地相关的儿科镇静指南可能有助于减少目前在资源有限的非洲地区提供安全儿科镇静的障碍。
■这项混合方法研究使用半结构化访谈描述了非洲提供者的儿科程序镇静实践。目的抽样用于确定在广泛地理区域的非洲资源有限环境中工作的关键线人，经济,和专业范围。同时收集有关提供者背景和镇静实践的定量数据，以及有关儿科程序镇静障碍的定性数据，以及改善其设置中儿科镇静实践的建议。所有采访都是转录的，编码,并分析了主要主题。
■38名主要线人参加了，代表19个国家和麻醉专业，手术,儿科,重症监护,急诊医学,和一般实践。儿科镇静最常见的指征是影像学（42%），最常见的药物是氯胺酮（92％），缺氧是最常见的不良事件（61%）。尽管92%的关键线人表示儿科程序镇静对他们的实践至关重要，只有一半的人表示感觉受到了充分的训练。关于安全儿科镇静障碍的三个主要定性主题是：缺乏资源，缺乏教育,以及缺乏跨站点和提供商的标准化。
■这项研究的结果表明，培训专门的儿科镇静团队，创建便携式“儿科镇静试剂盒，并制定当地相关的儿科镇静指南可能有助于减少目前在资源有限的非洲地区提供安全儿科镇静的障碍。
