Total procedural requirements as indication for emergency department sedation.

Indications for pediatric procedural sedation and analgesia are generally based on the need to manage pain or elicit cooperation for a single major procedure in the emergency department setting. However, multiple minor procedures such as vascular access, urethral catheterization, lumbar puncture, or superficial abscess drainage may be required in the care of a single child, and combining these activities may produce as much stress as a single major procedure. The use of procedural sedation in children based on total procedural requirements is proposed with 2 illustrative cases as examples of this concept.