Ensure that healthcare professional and assistant available and trained, with resus and monitoring equipment available. Should have a record of practical experience of sedation under supervision, WBAs etc.
Document informed consent.
Confirm time of last food and fluid – fasting not required for minimal sedation eg nitrous oxide, or where child will maintain verbal contact. Else 2-4-6 fasting rule.
Prepare child and family psychologically.
For painless procedure eg imaging, use choral (under 15kg), midazolam. For painful procedures, use nitrous oxide, oral/IN midazolam +/- local anaesthetic.
If unsuitable, ketamine or IV midazolam (+/- fentanyl) – combination of opioid and ketamine requires anaesthetic training.