Please note that the below program is subject to change.
09:00 - 17:30
On the day prior to the PROSA2021 conference the PROSA Sedation Provider Course will take place. This first ever European interdisciplinary course is a 1-day hands-on advanced training course for paediatricians, anaesthesiologists, emergency physicians and specialised nurses who already have experience with Procedural Sedation and Analgesia (PSA) in children.
The course consists of high-fidelity scenario training, interactive workshops and reflective group discussions. Learning objectives include PSA-related quality and safety, managing emergencies, performing deep sedation, interpreting capnography, process control, trust-based communication and implementing procedural comfort care.
Teaching team: Ten experienced instructors from different professional backgrounds with extensive expertise in PSA in children.
Maximum number of participants: 30 (5 interdisciplinary groups of 6 participants each). An interdisciplinary mix of participants from different European countries is sought.
Location: MUMC* simulation centre (just a few walking minutes away from the PROSA2021 Conference venue)
*Maastricht University Medical Centre
Registration and selection: Please apply for participation by sending an e-mail to Piet Leroy (firstname.lastname@example.org), describing shortly your professional background, what you expect to learn and a brief description of your experience with PSA in children. As soon as possible we will inform you whether or not you can take part in the course.
Cost and Payment: Nurses: € 150,00; Doctors: € 250,00.
Accreditation and Certificate: For Dutch Profesionals accreditation will be requested. All participants will receive a certificate of participation.
07:00 - 08:45
Registration – Coffee/Tea – Breakfast
08:45 - 09:00
Welcome and Introduction
09:00 - 12:00
Theme: The human factor
Piet Leroy (chair)
09:00 - 10:00
Empathy and Empathic blindness
10:00 - 10:45
Non-Verbal Communication in the patient-professional relationship
10:45 - 11:45
Placebo and Nocebo Effects
12:00 - 13:30
INTERACTIVE, CASE-BASED Lunch-WORKSHOPS (Registration required!) or LUNCH
Topic: ‘Lying Still’
Behavioral techniques for immobility during Imaging
Topic: ‘No More Tears’
Trauma Free Vaccination in infants, children & adolescents
Topic: ‘Not just a Poke’
Managing pain during Vascular Access procedures.
Topic: ‘Stiches and Fractures’
Creating an ouchless ER
Topic: ‘Changing the Talk of Town’
Comfort-directed Language & communication
Topic: ‘The Child with medical psycho-trauma’.
The use of EMDR in the clinical setting
Inge de Vlieger
Topic: Art Therapy as a supportive strategy for children during painful medical procedures
13:45 - 15:45
Theme: From Fear to Trust
Felix Kreier (Chair)
13:45 - 14:15
A true act of procedural comfort is knowing when not to act – a Parent’s perspective
14:15 - 15:00
Making a human connection: establishing trust with children
15:00 - 15:30
Rights based standards for children undergoing clinical procedures: an international collaborative good practice statement
15:45 - 16:15
Coffee/Tea Break with exhibitors
16:15 - 18:15
Theme: Strategies for Procedural Pain Relief
Mark Roback (chair)
16:15 - 16:50
Analgesia for Common Procedures in Children
16:50 - 17:25
Virtual Reality for procedural pain relief: when and how to use in daily practice
17:25 - 18:00
Lessons from the dental chair
Rick van der Pas
18:00 - 19:30
Social meeting - Reception – Entertainment
20:00 - 23:00
07:30 - 09:00
Registration – Coffee/Tea
07:30 - 08:45
BREAKFAST DRUG SESSIONS – MEET THE EXPERTS – Practical Pharmacology (Registration required!)
Breakfast drug session 1
Breakfast drug session 2
Breakfast drug session 3
Marga van Eck-Smaling
Breakfast drug session 4
Breakfast drug session 5
09:00 - 11:00
Theme: Procedural distress and sedation in infants and young children
Anna Taddio (chair)
09:00 - 09:30
Procedural Distress and Comfort in Neonates
09:30 - 10:00
Long-Term consequences of procedural pain at the young age
10:00 - 10:30
Procedural Sedation and Analgesia in the (Very) Young Children – Practical Pharmacology
10:30 - 11:00
Safety of Procedural Sedatives in young children: is neurotoxicity an issue?
11:30 - 13:00
INTERACTIVE, CASE-BASED Lunch-WORKSHOPS (Registration required!)
Topic: Language, Suggestion & Hypnosis for managing procedural distress
Topic: Clinical Cases I
Comfort strategies for Common Distressing Procedures
Sara de Bulpaep
Topic: Clinical Cases II
Sedation Strategies for Radiologic Imaging
Topic: Clinical Cases III
Comfort Strategies for Special Needs Children and children with Autism Spectrum Disorder
Topic: Capnography Monitoring during Procedural Sedation - Practical Exercises
Topic: Setting-up a sedation service in your hospital
Topic: Keeping Nitrous Oxide Safe for All – Measures for Controlling Occupational Exposure
13:15 - 15:15
Theme: Maximizing Safety during Procedural Sedation
Eva Schaffrath (chair)
13:15 - 13:45
Procedural Sedation and the Pediatric Airway: interactions and precautions
13:45 - 14:15
Pre-sedation fasting: an update of the evidence and the new ICAPS guidelines
14:15 - 14:45
Risk factors and adverse events in pediatric procedural sedation
14:45 - 15:15
Nitrous Oxide: Angel or Devil
15:15 - 15:45
Coffee/Tea Break with exhibitors
15:50 - 17:35
Theme: Training, Credentialing and Implementation
Annick De Jaeger (chair)
15:45 - 16:10
PSA Practice patterns in European Emergency Care Units: Challenges & Opportunities
16:10 - 16:35
Training pediatric ED staff in procedural sedation: achievements and lessons learnt
Trust me, I am a trained sedation provider!
Incorporating Entrustable Professional Activities into a pediatric sedation curriculum for specialized nurses
Marga van Eck-Smaling
17:00 - 17:30
Pediatric Procedural Sedation in Europe: Quo Vadis? Conference summary and debate
Jurgen de Graaff
Workshop Content Summary
IMPORTANT: All Workshops should be case-based, i.e. authentic clinical cases and scenario’s are used for interactive discussion. Use of slides should be limited to present cases and short summaries of essential learning points. Please do not give (mini)lectures during the workshop. Use of videography (i.e. filmed authentic cases) is strongly recommended.
DAY 1 Workshops
Workshop 1: ‘Lying still’
- Non-pharmacological strategies to help children lying still during imaging procedures (e.g. MRI scanning)
Workshop 2: ‘No more Tears’
- Many claim offering a patient-centered service when dealing with distressing procedures in children. But how much choice do we really grant to children and their parents? And how can we make patients/parents competent for making appropriate choices that contribute to optimal procedural perceptions and experiences?
- Anna Taddio developed with her team a method for active knowledge translation so that children/parents themselves can learn which methods work best for them. From the University of Toronto Website: “In the past, we’ve burdened the health-care provider with everything,” says Taddio. “But I think it’s better to show the kids and then they can choose how to best cope. In the end, Taddio says it’s all about medical community acknowledging the existence of pain and working with patients to reduce its impact during injections and other procedures. Treating pain has many benefits,” she says. “It not only prevents unnecessary suffering, it ensures we are delivering the best care possible, improves everyone’s satisfaction with the experience, and improves health because people are more likely to participate in positive health behaviours like getting vaccinated and going to a doctor to get a blood test to look for high cholesterol and these sorts of things.” (https://www.utoronto.ca/news/no-more-tears-publicly-funded-research-u-t-s-anna-taddio-taking-pain-out-vaccinations-canada)
Workshop 3: ‘Not just a Poke’
- Correct use of topical anesthetics (location, timing, tips – tricks, logistical challenges)
- Misconceptions (e.g. emla generates more failure of IV access)
- Other techniques (cooling, J-tip, subcutaneous infiltration of buffered lidocaine with a 30G needle, Buzzy,...): evidence, experiences, practices...
Workshop 4: ‘Stitches and Fractures’.
- How to create an ouchless ER
- Suggested procedures to discuss/to use for discussion: Wound care and suturing; Non-complex forearm fracture; Abscess drainage
- Points for discussion: patient approach; optimal local/topical techniques; when to use sedation? Which sedation (important point to discuss: indications versus limitations of nitrous oxide)
- IMPORTANT: Is Fentanyl (IN or IV) on its own sufficiently effective for fracture reduction or similar painful procedures?
- Key questions a professional should ask him/herself before starting procedures: (1) Is the child in pain before (i.e. in need for acute pain management). (2) Environmental setting. (3) Adaptive distraction possible? (4) How painful is the procedure anticipated by you, the family/child? (4) Use of topical analgesics. (5) Most optimal additional sedative (anxiolysis or deep sedation?)
Workshop 5: ‘Changing the Talk of Town’.
- Changing the way we talk as professionals with patients and with eachother
- Which words/sentences may harm and which kind of talk might enhance trust and feelings of comfort?
Workshop 6: The Traumatized Child
- Managing anticipatory Anxiety; Cognitive Behavioral Strategies; Desensitization
- What does ‘trauma’ mean
- Iatrogenic Post-Traumatic Stress Disorder; EMDR therapy
Workshop 7: Art Therapy as support for children during medical procedures
DAY 2 Workshops
Workshop 8: Language – Suggestion – Hypnosis
- How can words and suggestions influence patientcomfort?
- What is hypnosis?
- How can children use self-hypnosis to reduce their pain and anxiety?
Workshop 9: Clinical Cases I: comfort strategies for common Pediatric Procedures
- IV access
- Nasogastric tubes
- Urinary Catheters
Workshop 10: Clinical Cases II: Sedation for radiologic imaging
- Which children will need sedation? Which may benefit from non-pharmacology [Refer to Workshop 1 – Day 1]?
- Best practice for < 3-6 months; 6m-5 yrs; > 5 yrs
- Propofol? Dexmedetomidine (IV? IN? Doses?)
- Patient-centered sedation care on a radiology department. What is needed?
Workshop 11: Clinical Cases III: Comfort Strategies in special needs children and children with autism spectrum disorder
- For example: autism spectrum disorder, severe anxiety, hyperactivity, mental retardation,...
- How to involve parents/caretakers?
- Which drugs might be more optimal?
Workshop 12: Capnography – practical exercises
- Practical applications of capnography during dissociative and deep sedation
- Airway assessment: Using the waveform to detect normal ventilation abnormal ventilation including hypoventilation/respiratory depression, obstructive apnea (upper airway obstruction, laryngospasm), central apneas, and bronchospasm.
Workshop 13: Setting up a sedation Service in your Hospital
- Which conditions are needed (evidence-based protocols; transparency; inter-disciplinary collaboration; consistent care)
- Introducing TROOPS
- How to achieve a patient-centered service offering care tailored to individual comfort needs
Workshop 14: Keeping Nitrous Oxide Safe for All – Measures for Controlling Occupational Exposure
- Occupational toxicity of Nitrous Oxide and risks for Healthcare workers
- Measure to control occupational exposure