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We discussed this recently as well.

Our pediatric radiologists provided two reasons for withholding pain
medication/sedation.

One already noted is that crying and increased abdominal pressure may help
facilitate reduction. I guess that this is simply "common knowledge" rather
than evidence based medicine.

The other reason given was that they follow the child's mental status and
if there is any deterioration they will halt the procedure and send the
child to the OR. If the child is sedated, they are unable to use this
clinical information.

As I am not yet doing these reductions in the emergency department, I rely
on my radiologist colleagues to do what is right for the kids.

Rick
Inova Fairfax

On Mon, May 12, 2014 at 12:02 PM, Giora Weiser <[log in to unmask]>wrote:

> Hi,
> I am trying to find out what is the common practice in the big world...
> Here in Israel, when a child is diagnosed with an intussusception he will
> go to the radiology department for an air enema. There is a wide range of
> opinions whether sedation should be given for this procedure. The latest
> article that actually comes from Israel showed success with sedation.
> I was wondering what is accepted in the bigger medical centers? Is
> sedation used? Is it given by the EM people? A sedation service?
> Anesthisiology?
> Anyone know of good literature on the subject...?
>
> Thanks for the info,
> Giora Weiser
> Shaare Zedek Medical Center
> Jerusalem, Israel
>
> 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:
>                  http://listserv.brown.edu/ped-em-l.html
>

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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