6284 Knowledge, attitude and practices on paediatric procedural sedation/analgesia among a selected group of medical officers in Sri Lanka

Objectives To assess knowledge, attitudes and practices on paediatric procedural sedation and analgesia (PPSA) among a selected group of medical officers (MOs) working in general paediatric units in the Western Province of Sri Lanka. Methods A descriptive cross-sectional study was carried out, after obtaining ethical clearance from Ethics Review Committee of the Sri Lanka College of Paediatricians, on a convenience sample of MOs of all carrier levels, excluding consultants and post graduate trainees of other specialties allocated to general paediatric units, working for more than one month in general paediatric wards at teaching, district general and base hospitals in the Western Province- Sri Lanka. A self-administered pre-tested questionnaire based on latest American Academy of Paediatrics guideline on monitoring and management of paediatric patients before, during and after sedation for diagnostic and therapeutic procedures was used to collect data. Participants' knowledge on commonly used pharmacological agents for PPSA was assessed based on the latest edition of the BNFc. Data were analyzed using SPSS 27. Chi-square test was used when necessary. Results The study included 384 MOs. There were 43.8% (168/384) junior doctors and 56.2% (216/384) middle grade doctors. Out of the study participants 41.9% and 58.1% were from teaching and other hospitals respectively. Majority (66.4%) of them were not trained on PPSA formally. On average, a person has performed at least 5 procedures needing PPSA during their paediatric exposure, while there were 18(4.7%) junior doctors who have never done a procedure. Majority (63.8%) had experience of practicing ≤2 methods for PPSA and commonest (88.3%) method used was pharmacological agents. Practice and knowledge improved with seniority (p=0.00) and attending to formal training sessions (p=0.00). Both practice and knowledge were poor in MOs in Base hospitals (p=0.00). Majority of the study participants (63.8%) graded their knowledge on PPSA as average and 72.4% of the MOs strongly recommended formal training on PPSA. Conclusion Practice of non-pharmacological methods for PPSA was minimum among medical officers working in paediatric units in the Western Province of Sri Lanka. Formal teaching programmes on PPSA need to be conducted mainly focusing on junior doctors and medical officers in base hospitals in the Western Province of Sri Lanka.