Guidance for Implementing Pediatric Procedural Sedation in Resource-Limited Settings

Procedural sedation has become a routine pediatric practice in high-income countries with a goal to decrease procedural time and error rates while increasing patient, parent, and provider satisfaction. Unfortunately, procedural sedation is not commonly performed in resource-limited settings due to lack of training, provider availability, medication availability, monitoring and resuscitation equipment, and clinical practice guidelines specific for use in resource-limited settings. This article outlines the development of a pediatric sedation curriculum tailored specifically for use in low- and middle-income countries. This curriculum was piloted in Liberia for pediatric and surgical residents in 2016, and the challenges and next steps for broader implementation of such a curriculum are detailed here. Globally available pediatric procedural sedation is necessary to improve the health care and outcomes of children living in low- and middle-income countries.