Variations in sedating uncooperative, stable children for post-traumatic head CT

Pediatr Emerg Care. 1999 Aug;15(4):241-4.


Objective: To characterize variations among pediatric emergency physicians and their hospital facilities regarding sedation of the uncooperative, stable child for head CT following closed head injury.

Design: Mail survey with two follow-up mailings.

Participants: Surveys were sent to all members of the Emergency Medicine Section of the American Academy of Pediatrics (AAP).

Results: Of 596 surveys sent, 431 (72%) were returned, with 304 (51%) usable responses. Respondents annually sedate over 17,500 children for post-traumatic head CT. Formal training to sedate children for head CT was noted by 73%. Published guidelines for sedation are followed by 74%; 10% were unaware of the existence of published guidelines for sedation. Twenty-six percent of the respondents were very or somewhat dissatisfied with their sedation-related practices. In response to three clinical scenarios involving sedation of 8-month-old, 3-year-old, and 6-year-old children for head CT, midazolam was the most commonly chosen drug. Over 20 different sedation strategies were selected for each scenario.

Conclusions: Sedation practices for post-traumatic pediatric head CT vary widely, among both physicians and individual practitioners. Institutional and individual sedation-relation policies vary widely as well. Variation and dissatisfaction with sedation practices may reflect uncertainty regarding optimal sedation strategies. Further cost-effectiveness research is necessary.

Publication types

  • Comparative Study

MeSH terms

  • Child
  • Child Behavior
  • Child, Preschool
  • Data Collection
  • Drug Utilization*
  • Emergency Medicine* / standards
  • Guideline Adherence
  • Head Injuries, Closed / diagnostic imaging*
  • Head Injuries, Closed / psychology
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Infant
  • Pediatrics
  • Practice Patterns, Physicians'
  • Tomography, X-Ray Computed* / psychology
  • United States


  • Hypnotics and Sedatives