So frustrating, Fernando -
If there are hospitals which your leadership regards as flagships or
standards of care, get their ED sedation policies (provided they're deep
sedation hospitals). Letters or guidelines from hospitals your hospital
regards well may help your case.
Obviously, papers from the SPS will be good adjuncts, but maybe not as
powerful as "all the big kids are allowed to do it" type arguments.
You can also ask a grand rounds speaker in who blithely talks about all of
the above as if it's way old hat. Which it is. And if someone asks a
question and says "we can't use x, what's the next best thing", they won't
be feigning their shock and pity.
Amy Baxter MD FAAP FACEP
Pediatric Emergency Medicine Associates
[log in to unmask] writes:
>Ask anesthesia to be available within 20 minutes of your request to
>perform all of your sedations since what truly concerns them is patient
>care. And make sure that they are available 24 hours per day 365 days
>per year. While you are at it, ask them to give you even faster
>availability for all PED intubations, since obviously you can't handle
>the complications associated with these drugs. I am sure that they will
>be helpful then.
>Sent from my iPad
>On Feb 13, 2013, at 10:19 AM, Fernando G Mendoza <[log in to unmask]>
>> Dear Group-
>> We practice as a pediatric hospital within a larger hospital system.
>> As we move to computerized order sets, our Anesthesia Dept is again
>threatening to fight us on the use of Ketamine / Etomidate in the ED for
>procedural sedation. (Don't even mention Propofol!)
>> I know many of you have been through this battle before....I have
>position statements ready from the AAP and Anesthesia Society. Any other
>recommendations or strategies? This could go to a confrontation at the
>MEC level, where we'll have to convince adult surgeons, etc. of our
>plight. Our Adult ED colleagues will support us, since they have been
>fighting the same battle as well.
>> Thanks in advance,
>> Fernando G. Mendoza, MD, FAAP
>> Medical Director, Children's Emergency Center
>> Baptist Children's Hospital
>> Miami, FL
>> For more information, send mail to [log in to unmask] with the
>message: info PED-EM-L
>> The URL for the PED-EM-L Web Page is:
>For more information, send mail to [log in to unmask] with the
>message: info PED-EM-L
>The URL for the PED-EM-L Web Page is:
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is: