Stamper Matthew J, Hawks Sharon J, Taicher Brad M, Bonta Juliet, Brandon Debra H
AORN J. 2014 Apr;99(4):480-94. doi: 10.1016/j.aorn.2013.08.019.
Pediatric emergence delirium is a postoperative phenomenon characterized by aberrant cognitive and psychomotor behavior, which can place the patient and health care personnel at risk for injury. A common tool for identifying emergence delirium is the Level of Consciousness-Richmond Agitation and Sedation Scale (LOC-RASS), although it has not been validated for use in the pediatric population. The Pediatric Anesthesia Emergence Delirium Scale (PAED) is a newly validated tool to measure emergence delirium in children. We chose to implement and evaluate the effectiveness and fidelity of using the PAED Scale to identify pediatric emergence delirium in one eight-bed postanesthesia care unit in comparison with the traditional LOC-RASS. The overall incidence of pediatric emergence delirium found by using the LOC-RASS with a retrospective chart review (3%) was significantly lower than the incidence found by using the LOC-RASS (7.5%) and PAED Scale (11.5%) during the implementation period. Our findings suggest that the PAED Scale may be a more sensitive measure of pediatric emergence delirium, and, in the future, we recommend that health care personnel at our facility use the PAED Scale rather than the LOC-RASS.
小儿苏醒期谵妄是一种术后现象，其特征为认知和精神运动行为异常，这可能使患者及医护人员面临受伤风险。用于识别苏醒期谵妄的常用工具是意识水平-里士满躁动镇静量表（LOC-RASS），不过该量表尚未在儿科人群中得到验证。小儿麻醉苏醒期谵妄量表（PAED）是一种新验证的用于测量儿童苏醒期谵妄的工具。我们选择在一个有八张床位的麻醉后护理单元实施并评估使用PAED量表识别小儿苏醒期谵妄的有效性和准确性，并与传统的LOC-RASS进行比较。通过回顾性病历审查使用LOC-RASS发现的小儿苏醒期谵妄总体发生率（3%）显著低于实施期间使用LOC-RASS（7.5%）和PAED量表（11.5%）所发现的发生率。我们的研究结果表明，PAED量表可能是小儿苏醒期谵妄更敏感的测量工具，并且在未来，我们建议我们机构的医护人员使用PAED量表而非LOC-RASS。
