Perceived safety is a valuable care-quality observation but is not the same outcome as prospectively measured complications.
Fifty-one pediatric nurses at one teaching hospital rated four sedative regimens. Median overall satisfaction was higher for midazolam, propofol and dexmedetomidine than ketamine. Perceived safety ratings did not differ significantly, and most respondents also considered non-drug preparation important.
The questionnaire was not validated, the sample was small and exposure to each drug varied among nurses. The study did not randomize patients or count adverse events under equivalent conditions. Similar safety ratings cannot demonstrate equal respiratory or cardiovascular safety.
In a quality-of-care opinion, keep staff experience separate from patient outcomes. Explore whether different agents were used for different procedures or more difficult patients. The findings can guide questions about workflow and training, but they do not establish that the highest-rated sedative was objectively safest for a given child.
Source reviewed: Nurses Perceptions of the Quality of Procedural Sedation in Children Comparing Different Pharmacolog (PMC9315654). Forensic applications above are interpretive analysis of the supplied publication.
Related reading: Pediatric Sedation Z-Scores Were Relative Burden Measures Rather Than Dose Equivalents.