Incidence and stratification of adverse events associated with sedation: Is there a benchmark?

A signifi cant and growing number of children receive sedation for procedures performed outside of the operating room each year. While a large number of studies have reported on adverse events occurring in association with procedural sedation in many of these settings, benchmarks for sedation adverse event rates have not been formally established. The intent of this chapter is to add some clarity to the concept that, unlike adverse outcomes (e.g., death, permanent neurologic injury) that are largely preventable and should not occur, the occurrence of adverse events is unavoidable, and acceptable rates of adverse events should exist. Once acceptable rates of sedation adverse events are established, sedation providers and programs should be able to compare their individual outcomes to these national and international standards. This chapter will examine current sedation practice outside the operating room and associated adverse events. It will focus on important barriers that must be overcome before meaningful adverse event rates may be determined and best practice guidelines established.