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New advice is being developed to improve NHS standards on sedating anxious young patients. There is currently no national guidance, which means those aged 19 and under who need sedation before a therapeutic or diagnostic procedure might be given drugs that may be ineffective or unsafe.

The National Institute for Health and Clinical Excellence (NICE) has today published draft recommendations for the NHS on the safe and effective use of sedation for children and young people aged up to 19 years. These are now open for consultation with final guidance to be published towards the end of the year.

Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE, said: “This guideline focuses on how best to sedate young people who need a diagnostic test, like a biopsy or MRI scan, or a therapeutic procedure such as correcting a dislocated joint. It's also relevant for dentists who need to sedate anxious patients.

“The NHS uses numerous sedation techniques but there's little guidance on which are most effective and what resources are needed to administer them safely. This guideline, once published, will promote best practice on the use of sedation techniques and standardise the level of care children, young people and their families can expect from the NHS.”

Around 2 million children and young people visit hospital A&E departments every year due to accidental injuries1 and many will need to undergo procedures where sedation is required. It can also be useful in preventing the patient moving during diagnostic tests such as scans. Unlike adults, many youngsters may require sedation for these procedures as they may not understand the need to keep still, or could find them frightening, or the child may be too ill, in pain or have behavioural problems.

Dr Macbeth added: “Sedation can play an important role in helping alleviate anxiety or pain, which is why it's vital that techniques are administered correctly. Unsuccessful sedation can be very traumatic for the child and if the dosage of a drug is too great, it can lead to breathing difficulties which may result in brain injury or even death.”

The guideline makes a series of recommendations for hospitals and primary care settings on the use of sedation techniques. The draft recommendations are available for consultation and can be viewed at: http://guidance.nice.org.uk/CG/Wave18/52. All comments must be received by 2 July 2010.

1 Audit Commission / Healthcare Commission (2007) Better safe than sorry: preventing unintentional injury to children. London: Audit Commission