Sedation of pediatric patients for minor laceration repair: effect on length of emergency department stay and patient charges
| Autor: | Seth W. Wright, Laurie M. Lawrence |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Male
medicine.medical_specialty Minor laceration medicine.drug_class Sedation Midazolam Cohort Studies medicine Humans Hypnotics and Sedatives Ketamine Facial Injuries Retrospective Studies Anesthetics Dissociative business.industry Retrospective cohort study General Medicine Emergency department Length of Stay Hospital Charges Tennessee humanities Anesthesia Sedative Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Emergency Medicine Cost analysis Female medicine.symptom business Emergency Service Hospital medicine.drug |
| Zdroj: | Pediatric emergency care. 14(6) |
| ISSN: | 0749-5161 |
| Popis: | Sedating children can facilitate minor laceration repair by minimizing physical and psychic discomfort. However, some clinicians are reluctant to use sedation, in part because of concern about increased patient charges and fear that the emergency department (ED) stay will be prolonged. The purpose of this study was to determine the extent to which sedative use during the repair of simple facial lacerations in children increased the length of ED stay and patient charges.This was a retrospective cohort study of 152 children with small, simple, facial lacerations. Patients with complex lacerations and those requiring specialty consultation were excluded. Patients, at the discretion of the treating physician, received either intramuscular ketamine (n = 14), intranasal or rectal midazolam (n = 38), or no sedation (n = 100). Length of ED stay and the total patient charges were analyzed.Groups were equal with respect to age, sex, and length of the wound. The mean patient time in the ED, from placement in examination room to discharge, was significantly longer for those given ketamine (149+/-37 minutes) and midazolam (98+/-31 minutes) compared with those given no sedation (82+/-28 minutes). Patient charges were also higher in those given ketamine ($695+/-172) or midazolam ($498+/-153) compared with those receiving no sedation ($390+/-86).The results of this study demonstrate that sedation with ketamine or midazolam increases the length of ED stay compared with using no sedation. However, the increased lengths of stay were modest, particularly for midazolam. Fear of prolonged recovery time should not dissuade clinicians from using either sedative for minor procedures. The patient charges are considerably higher with both midazolam and ketamine, but they may not reflect the actual cost of patient care. |
| Databáze: | OpenAIRE |
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