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System-wide process changes improve procedural sedation billing in the pediatric emergency department

Published:March 17, 2018DOI:https://doi.org/10.1016/j.ajem.2018.03.037
      Procedural sedation and analgesia is common in the emergency department (ED). Data from the Nationwide Emergency Department Sample found that at least 80 children are sedated in the ED every day across the United States, accounting for 0.1–1.5 sedation cases per 1000 visits [
      • Allareddy V.
      • Rampa S.
      • Auslendar M.
      • Lowrie L.
      Trends in the Utilization of Moderate Sedation in Children in Emergency Departments in the USA.
      ,
      • Sacchetti A.
      • Stander E.
      • Ferguson N.
      • Maniar G.
      • Valko P.
      Pediatric Procedural Sedation in the Community Emergency Department: results from the ProSCED registry.
      ]. Laceration repair, fracture reduction, and abscess incision and drainage are the top conditions requiring PSA in the ED [
      • Bhatt M.
      • Johnson D.W.
      • Chan J.
      • Taljaard M.
      • Barrowman N.
      • Farion K.J.
      • et al.
      Risk factors for adverse events in emergency department procedural sedation for children. Sedation Safety Study Group of Pediatric Emergency Research Canada (PERC).
      ]. PSA has been shown to be safe and effective in the hands of trained multidisciplinary practitioners in the ED [
      • Bhatt M.
      • Johnson D.W.
      • Chan J.
      • Taljaard M.
      • Barrowman N.
      • Farion K.J.
      • et al.
      Risk factors for adverse events in emergency department procedural sedation for children. Sedation Safety Study Group of Pediatric Emergency Research Canada (PERC).
      ,
      • Grunwell J.R.
      • Travers
      • CE McCracken
      • Scherrer P.
      • Stormorken A.
      • Chumpitazi C.E.
      • et al.
      Procedural sedation outside the operating room using ketamine in 22,645 children: a report from the pediatric sedation research consortium.
      ].

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