{
  "abstract": "Aim Echocardiograms are a non-invasive ultrasound tool needed to examine the heart. To obtain concise imaging can be a considerable challenge due to crying, screaming, and persistent resistance to sitting still. Chloral hydrate is routinely used to sedate young children before imaging studies. 1 The aims of this retrospective audit are as below:– To identify the effectiveness of sedated echocardiograms (ECHO) with chloral hydrate.– Identify the proportion of patients who have been appropriately sedated for their ECHO (neuro–disability, global developmental delay, learning difficulty).– Identify alternative agents used if chloral did not sufficiently sedate patient.2 Method The number of admissions for sedated echo day-cases on one ward between 1st April 2024 to 31st December 2024 were gathered retrospectively using the reporting function on electronic records. Patients admitted for sedated echo were identified individually from documentation in their records. Electronic records of patients were searched using keywords such as ‘chloral, sedated ECHO, cardiology, cardiothoracic, cardiac ward’.All information was recorded on to a data tool set on Microsoft Excel. For patients where sedation was not explicitly recorded, the effectiveness of sedation was assessed qualitatively by the quality of the echo obtained.Results There was a total of 1176 admissions to the cardiac day case ward in the investigated timeframe and 229 cases were administered chloral hydrate. Of these, 30 cases were under cardiology and admitted for sedated ECHOs. This equates to 29 patients as one of the patients had 2 admissions during this timeframe.Image quality Images were unable to be obtained from 2 patients and suboptimal/incomplete images were obtained in 5 cases. Successful ECHOs were obtained in a total 23 cases. The 1 patient with 2 admissions had one admission with unobtainable imaging and another with where only a short functional echo was completed.Patient cohort11 out of 23 patients had documentation of a learning disability, (global) developmental delay, or autism. 81% (n=9) of patients had successful ECHOs (excluding poor/partial images) following chloral administration.Number of doses administeredOut of 23 patients 13% (n=3) received two doses of chloral hydrate prior to an ECHO.Conclusion Overall, results indicate that chloral hydrate was appropriately administered in 48% of cases and is an effective sedative for a number of patients. No alternative agent was identified in the three cases where sedation was not achieved. These findings indicate the need for clearer eligibility criteria or better documentation, in addition to consideration of alternative sedating agents for patients in which chloral hydrate is ineffective. The next steps are to carry out a literature review for alternative sedatives and develop internal guidelines to ratify practice.References Summary of Product Characteristics, ‘Chloral Hydrate 143mg/5ml Oral Solution,’ Electronic Medicines Compendium, 21st May 2024. [Online]. Available: https://www.medicines.org.uk/emc/product/8136/smpc#gref. [Accessed 02 07 2025].Yuen VM, Li BL, Cheuk DK, et al. A randomised controlled trial of oral chloral hydrate vs. intranasal dexmedetomidine before computerised tomography in children. Association of Anaesthetists 2017;72:1191–1195.",
  "authors": [
    {
      "affiliations": [
        "Great Ormond Street Hospital, UK"
      ],
      "name": "Sue Wong"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital, UK"
      ],
      "name": "Clare McCourt"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital, UK"
      ],
      "name": "Sadhna Sharma"
    }
  ],
  "title": "P19 An audit on the effectiveness of sedated echocardiograms in paediatric cardiac patients",
  "uid": "6b9176ae-d6bb-5c94-b2e7-0ec9a86785f0"
}