Grant: Planning Grants: Priority Announcement - Reproductive and Child Health

We propose a workshop to be held at the Sheraton Gateway Hotel in Toronto on March 5th, 2012 to develop a research proposal to examine the safety of medications used for sedation in the emergency department in the pre-school population. Sedation is commonly used in the emergency department in this population to minimize pain, awareness and motion for procedures such as re-aligning broken bones and dislocations, radiologic imaging that requires the child to remain still and repairs of complex lacerations. There is a recent concern that the agents used for sedation may be causing long-term intellectual impairment and developmental problems when administered to infants and toddlers from mid-gestation until the third year of life. Evidence in animal models unequivocally shows that these medications cause toxic effects in the developing animal brain, however, the effect on human infants and toddlers has yet to be established. Several retrospective human studies have been conducted but are inconclusive. No prospective studies in humans have been published to date. Given the high frequency of emergency department sedation in preschool children, the potential for serious medication effects and absence of studies in the emergency department setting, there is a great need for a definitive investigation to determine whether the current standard of care in managing procedural pain is ultimately harmful to the children we are treating. We propose a prospective, multi-centre study in seven Canadian pediatric emergency departments to address this important question.