Key priorities for implementation

Personnel and training

  • Healthcare professionals delivering sedation should have knowledge and understanding of and competency in:

    • sedation drug pharmacology and applied physiology

    • assessment of children and young people

    • monitoring

    • recovery care

    • complications and their immediate management, including paediatric life support.

  • Healthcare professionals delivering sedation should have practical experience of:

    • effectively delivering the chosen sedation technique and managing complications

    • observing clinical signs (for example, airway patency, breathing rate and depth, pulse, pallor and cyanosis, and depth of sedation)

    • using monitoring equipment.

  • Ensure that all members of the sedation team have basic life support skills for minimal, moderate and deep sedation. At least 1 team member should have intermediate life support skills for moderate sedation and advanced life support skills for deep sedation. Minimal sedation includes sedation with nitrous oxide alone (in oxygen) and conscious sedation in dentistry.

  • Healthcare professionals delivering sedation should have documented up‑to‑date evidence of competency including:

    • satisfactory completion of a theoretical training course covering the principles of sedation practice

    • a comprehensive record of practical experience of sedation techniques, including details of:

      • sedation in children and young people performed under supervision

      • successful completion of work‑based assessments.

Clinical environment and monitoring

  • For deep sedation continuously monitor, interpret and respond to all of the following:

    • depth of sedation

    • respiration

    • oxygen saturation

    • heart rate

    • three‑lead electrocardiogram

    • pain

    • coping

    • distress.

  • Also continuously monitor, interpret and respond to the following, provided that monitoring does not cause the patient to awaken and so prevent completion of the procedure:

    • end tidal CO2 (capnography)

    • blood pressure (monitor every 5 minutes)

      The healthcare professional administering sedation should be involved only in continuously monitoring, interpreting and responding to all of the above.