Table 4.
Relationships between European emergency department characteristics and existence of clinical components spanning safety, technology, and human resources around pediatric procedural sedation and analgesia
| Number of children seen per year (terciles) | Frequency of IV sedation | Belonging to a university or tertiary care center | Existence of a board certification in pediatric emergency medicine | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 50–12,000 n = 60 |
12,000–31,000 n = 55 |
31,000 to max n = 57 |
p | Adjusted p | Less than 1/week n = 43 |
About 1–2/week n = 34 |
About 2–6/week n = 39 |
1/day or more n = 30 |
p | Adjusted p | No n = 29 | Yes n = 142 | p | Adjusted p | No n = 139 | Yes n = 32 | p | Adjusted p | |
| Specific PSA curriculum | 22 (37%) | 27 (49%) | 33 (58%) | 0.26 | 0.555 | 23 (54%) | 16 (47%) | 21 (54%) | 17 (57%) | 0.485a | 0.701 | 13 (45%) | 69 (49%) | 0.445a | 0.712 | 60 (43%) | 22 (69%) | 0.015a | 0.049a |
| Specific number of supervised PSA | 26 (44%) | 22 (40%) | 25 (44%) | 0.687 | 0.687 | 18 (42%) | 12 (35%) | 22 (56%) | 17 (57%) | 0.426a | 0.701 | 12 (41%) | 61 (43%) | 0.999a | 0.999 | 51 (37%) | 22 (69%) | 0.001a | 0.007a |
| General safety rules for administering sedation | 43 (73%) | 39 (71%) | 45 (80%) | 0.11a | 0.392 | 33 (77%) | 27 (79%) | 29 (74%) | 28 (93%) | 0.361a | 0.701 | 18 (62%) | 109 (77%) | 0.189a | 0.712 | 98 (71%) | 29 (91%) | 0.058a | 0.108 |
| PSA checklist | 27 (46%) | 27 (49%) | 33 (58%) | 0.14a | 0.392 | 25 (58%) | 17 (50%) | 22 (56%) | 20 (67%) | 0.848a | 0.919 | 15 (52%) | 72 (51%) | 0.526 | 0.712 | 66 (48%) | 21 (66%) | 0.125a | 0.203 |
| Capnography | 31 (53%) | 22 (40%) | 26 (46%) | 0.404 | 0.589 | 17 (40%) | 15 (44%) | 24 (62%) | 18 (60%) | 0.132 | 0.510 | 11 (38%) | 68 (48%) | 0.327 | 0.712 | 59 (43%) | 20 (63%) | 0.04 | 0.104 |
| Medical sedation service | 30 (51%) | 32 (58%) | 27 (47%) | 0.506 | 0.590 | 18 (42%) | 23 (68%) | 19 (49%) | 14 (47%) | 0.138 | 0.510 | 13 (49%) | 76 (54%) | 0.393 | 0.712 | 79 (57%) | 10 (31%) | 0.009 | 0.039a |
| Nurse-directed triage analgesia | 24 (41%) | 26 (47%) | 40 (70%) | 0.004 | 0.056 | 20 (47%) | 18 (53%) | 20 (51%) | 19 (63%) | 0.561 | 0.719 | 10 (35%) | 80 (56%) | 0.032 | 0.416 | 70 (50%) | 20 (63%) | 0.215 | 0.291 |
| Hypnosis | 12 (20%) | 4 (7%) | 9 (16%) | 0.136 | 0.392 | 5 (12%) | 6 (18%) | 6 (15%) | 7 (23%) | 0.608 | 0.719 | 4 (14%) | 21 (15%) | 0.89 | 0.999 | 21 (15%) | 4 (13%) | 0.707 | 0.707 |
| Child life therapists | 5 (9%) | 2 (4%) | 10 (18%) | 0.044 | 0.308 | 5 (12%) | 3 (9%) | 4 (10%) | 4 (13%) | 0.946 | 0.946 | 2 (7%) | 15 (11%) | 0.548 | 0.712 | 13 (9%) | 4 (13%) | 0.592 | 0.641 |
p value refers to chi-square test. Adjusted p value refers to the adjustment for multiple comparisons by the Benjamini–Hochberg method
PSA procedural sedation and analgesia, IV intravenous
aFisher exact test