Procedural sedation programme minimising adverse events: a 3-year experience from a tertiary paediatric emergency department.

Introduction: A well-developed procedural sedation programme in the paediatric emergency department can minimise adverse events. We examined how adherence to current best evidence ensures safe delivery of paediatric sedation in a newly established tertiary paediatric hospital.

Methods: Our sedation service uses a robust provider training and privileging system, standardised policy and procedures and rigorous data collection all within an evidence-based clinical governance process.

Reply to: Magnesium sulphate intravenously reduces tachycardia side-effects of β-agonists.

https://bit.ly/3pPnGKl.

Stating the obvious: intravenous magnesium sulphate should be the first parenteral bronchodilator in paediatric asthma exacerbations unresponsive to first-line therapy.

What is the most appropriate second-line intravenous bronchodilator treatment when a child with a severe asthma attack is not responsive to initial inhaled therapy? The second-line treatment options for acute asthma include parenteral β-agonists, methylxanthine and magnesium sulphate (MgSO). There is a poor evidence-base to inform this decision. This review argues that intravenous MgSO is the obvious treatment of choice for this situation as the initial treatment based on current knowledge.