Improving Identification of Pediatric Emergence Delirium in the Post Anesthesia Care Unit: A Quality Improvement Opportunity

J Perianesth Nurs. 2022 Dec;37(6):770-773. doi: 10.1016/j.jopan.2021.12.004. Epub 2022 Jun 9.

Abstract

Objective: This article offers a recommendation on how the Pediatric Assessment Emergence Delirium Scale (PAEDS) could be implemented in the post anesthesia care unit (PACU) to improve the assessment and treatment of pediatric emergence delirium (PED).

Background: PED is an anticipated complication in the PACU characterized by mental confusion, irritability, disorientation, inconsolable crying, and prolonged postanesthetic recovery time. Although it is a short-lived phenomenon, it increases the risk for traumatic injuries and may lead to a decrease in overall parent satisfaction with their child's surgical experience.

Method: Implementation of the PAEDS in the PACU has the potential to improve the care and safety of the surgical pediatric patient population and could be a catalyst for PED process improvements. This tool has been used in various studies and has demonstrated the validity and reliability in the assessment of emergence delirium.

Conclusions: Clinical use of the PAEDS is not standard of practice, but considering the adverse effects of PED on patients, parents, and medical staff, a PAEDS protocol could be beneficial to the PACU.

Keywords: emergence agitation; emergence delirium; pediatrics.

MeSH terms

  • Anesthesia Recovery Period
  • Anesthesia, General / methods
  • Child
  • Emergence Delirium* / epidemiology
  • Humans
  • Prospective Studies
  • Quality Improvement
  • Reproducibility of Results