Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Kwok V, Tang GSM, Hui LK, Chu WL, Law NW, Mok YT, Yuen V
Affiliation :
Department of Anaesthesiology & Perioperative Medicine, Hong Kong Children's Hospital
Introduction :
Dedicated paediatric sedation services facilitate significant advancement of an array of diagnostic and therapeutic procedures. The Department of Anaesthesiology at the Hong Kong Children's Hospital (HKCH) recognized the importance of such service and has introduced elective and emergency sedation services for the paediatric patients in non-operating room areas since the commencement of clinical service at HKCH. The Department served near 900 patients in radiology units, nuclear medicine departments and paediatric wards annually.
Objectives :
This presentation aims to review the sedation service provided by the Department of Anaesthesiology from 2022 to 2023.
Methodology :
Data including patient demographic, procedure type and duration, sedation modality, post-sedation side effects was retrieved from the clinical information system.
Result & Outcome :
Between 2022 – 2023, more than 1500 patients received sedation service at HKCH. Forty-nine percent of the patient were classified as ASA 3 or above. 12.5% and 50.9% of the patient were below age of 1 and 6 years respectively. About 10% of the patient required general anaesthesia. The median (IQR) duration of MRI procedure was 46 (32-60) and it was significantly longer than other non-MRI interventions (20 (13-39), p<0.0001). 21.9% of the parent reported prolong sleepiness after sedation, 12.6% reported restlessness, other post-sedation side effects including GI upsets, hyperactivity, medical consultation, motor imbalance and difficulty in breathing were 3.9%, 5.9%, 0.8%, 3.1% and 0.7% respectively. Satisfaction rate to sedation service was over 90%. Successful diagnostic and therapeutic procedures play a significant role in patient’s journey. The procedure can be life-changing with great impact. (1) In the past, diagnostic and therapeutic procedures required invasive surgical approaches and were limited to operating theatres. However, advancements in interventional radiology and sedation techniques by anaesthesiologists have revolutionized these procedures. Now, with the combined efforts of these teams, procedures such as central line insertion, tissue biopsy, and chemoembolization can be performed with minimal invasiveness, resulting in reduced pain and eliminating the need for general anesthesia. This not only decreases operating and recovery times but also allows for same-day discharges, improving overall efficiency and safety. (2) enabling more effective hearing tests and reducing the need for hearing aids among children previously deemed to have hearing issues and allowing subsequent appropriate school placement. (3) established the Miscellaneous List in 2021, facilitating procedures across various specialties for high-risk pediatric in-patients, notably those with mucopolysaccharoidosis, in the operating theatre with single sedation, thereby reducing multiple hospital admissions and post-procedure PICU stays. The streamlined process enhances patient safety, comfort and outcome. HKCH Department of Anaesthesiology is keen to share these interdisciplinary strategies and discuss future challenges and opportunities.
