Guidelines for the elective use of conscious sedation, deep sedation, and general anesthesia in pediatric patients.

Terms used in this document are defined as follows: Pediatric patients: Includes all patients who are infants, children, and adolescents less than age of 0 majority. Must or shall: Indicates an imperative need and/or duty; as essential or indispensable; mandatory. Should: Indicates the recommended manner of obtaming the standard; highly desirable. May or could: Indicates freedom or liberty to follow a suggested or reasonable alternative. Conscious sedation: Conscious sedation is a minimally depressed level of consciousness that retains the patient’s ability to maintain a patent airway independently and continuously, and respond appropriately to physical stimulation and/or verbal command, eg, “Open your eyes.” For the very young or handicapped individual, incapable of the usually expected verbal responses, a minimally depressed level of consciousness for that individual should be maintained. The caveat that loss of consciousness should be unlikely is a particularly important part of the definition of conscious sedation, and the drugs and techniques used should carry a margin of safety wide enough to render unintended loss of consciousness unlikely. Deep sedation: Deep sedation is a controlled state of depressed consciousness or unconsciousness from which the patient is not easily aroused, which may be accompanied by a partial or complete loss of protective reflexes, including the ability to maintam a patent airway independently and respond purposefully to physical stimulation or verbal command. General anesthesia: General anesthesia is a controlled state of unconsciousness accompanied by a loss of protective reflexes, including the ability to maintain an airway independently and respond purposefully to physical stimulation or verbal cornmand.