Format

Send to

Choose Destination
Am J Emerg Med. 2019 Jan;37(1):85-88. doi: 10.1016/j.ajem.2018.04.063. Epub 2018 Apr 30.

Adverse events and satisfaction with use of intranasal midazolam for emergency department procedures in children.

Author information

1
Connecticut Children's Medical Center, Hartford, CT 06106, USA. Electronic address: lmalia@connecticutchildrens.org.
2
Connecticut Children's Medical Center, Hartford, CT 06106, USA. Electronic address: mlaurich@connecticutchildrens.org.
3
Connecticut Children's Medical Center, Hartford, CT 06106, USA. Electronic address: jsturm01@connecticutchildrens.org.

Abstract

PURPOSE:

Procedural sedation is commonly performed in the emergency department (ED). Having safe and fast means of providing sedation and anxiolysis to children is important for the child's tolerance of the procedure, parent satisfaction and efficient patient flow in the ED.

OBJECTIVE:

To evaluate fasting times associated with the administration of intranasal midazolam (INM) and associated complications. Secondary objectives included assessing provider and caregiver satisfaction scores.

METHODS:

A prospective observational study was conducted in children presenting to an urban pediatric emergency department who received INM for anxiolysis for a procedure or imaging. Data collected included last solid and liquid intake, procedure performed, sedation depth, adverse events and parent and provider satisfaction.

RESULTS:

112 patients were enrolled. The mean age was 3.8 years. There were no adverse events experienced by any patients. Laceration repair was the most common reason for INM use. The median depth of sedation was 2.0 (cooperative/tranquil). The median liquid NPO time was 172.5 min and the median NPO time for solids was 194.0 min. 29.8% were NPO for liquids ≤2 h and 62.5% were NPO for solids ≤2 h. Parent and provider satisfaction was high: 90.4% of parents' and 88.4% of providers' satisfaction scores were a 4 or 5 on a 5 point Likert scale.

CONCLUSION:

Our data suggest that short NPO of both solids and liquids are safe for the use of INM. Additionally, parent and provider satisfaction scores were high with the use of INM.

KEYWORDS:

Anxiolysis; Intranasal midazolam; Satisfaction

PMID:
29730093
DOI:
10.1016/j.ajem.2018.04.063

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center