Four health organizations have added their endorsements to recent guidance from the AAP and American Academy of Pediatric Dentistry (AAPD) that aims to improve the safety of pediatric patients undergoing dental sedation.
The American Society of Anesthesiologists, Society for Pediatric Anesthesia, American Society of Dentist Anesthesiologists and Society for Pediatric Sedation issued a statement (http://bit.ly/2LO9miP) supporting a joint AAP-AAPD clinical report, which recommends at least two individuals with specific training and credentials should be present with a pediatric patient receiving deep sedation/general anesthesia for dental treatment.
The report, Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures(http://bit.ly/2YqBSgb), replaces the “personnel” section of 2016 guidance that called for only one trained person to be present during procedures in a dental facility or hospital.
According to the new recommendations, sedation must be administered by a qualified anesthesia provider (a medical anesthesiologist, certified registered nurse anesthetist, dentist anesthesiologist or second oral surgeon). In addition, a second person must be present and have the skills to assist in an emergency, with the ability to monitor the patient, manage the airway, establish venous access for the administration of rescue medications and perform resuscitation. The second person must be an independent observer with no other responsibilities.
The stronger guidance followed recent deaths of children in the dental setting in which inadequate supervision may have played a role.
AAP President Kyle E. Yasuda, M.D., FAAP, welcomed the additional endorsements.
“We are pleased with the support from these influential health organizations on dental sedation guidelines, which take into account the unique vulnerabilities of children. As health care providers, we share a desire for children to receive close supervised care led by a team of skilled professionals,” he said.
