Abstract
Procedural sedation and analgesia in children require a systematic approach to establish patient safety. Failure to rescue the patient and the absence of system issues have been key components in sedation disasters in the past. Points of interest include informed consent, pre-sedation history taking, and physical examinations especially focused on the airway, proper fasting prior to elective procedures, appropriate monitoring and emergency equipment, backup emergency services, independent personnel responsible only to monitor and assist the patient during the procedure, documentation, and appropriate monitoring and staffing during recovery. Issues are essentially the same in children with heart disease and are described here.
