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Non-pediatricians will often sedate to deeper levels than pediatricians and electively intubate patients. Therefore, pediatricians who encounter selleckchem patients with potential for having a difficult airway or higher ASA class feel more inclined to use child life services or distraction techniques to accomplish the procedure without sedation or with minimal amounts of sedation medication. Because the non-pediatrician group may electively intubate and sedate patients to a deeper level, child life and distraction techniques may be less utilized. Also, because pediatricians sedate for more non-painful procedures, anxiety related to these procedures may be more amenable to the application of distraction techniques than anxiety related to painful procedures. It is important to view the statistical comparisons in this paper in light of the large sample. Highly statistically significant results are possible even when the magnitude of the difference is relatively small. For example, we were able to detect a difference for airway obstruction of 0.4% among pediatricians compared with 0.8% among other providers with P LY2109761 in vitro as follows: 324 cases for the pediatrician group and 1683 cases for the non-pediatrician group. This amount is unlikely to change the percentage to any significant degree in both the pediatrician and non-pediatrician groups. As stated, this study is prospective and observational in nature. Limitations of this study are clear. The institutions involved select themselves for inclusion and are voluntarily reporting their outcomes. As such, it is very likely that we are looking at a highly motivated and organized set of sedation systems that would outperform less organized systems. Because there is no control group, we did not attempt to draw direct cause and effect from these data.[24] There may be variability in sedation training or knowledge base among the pediatricians in the PSRC because sedation training in pediatric residency programs and fellowships varies. Any training in sedation after residency Oxacillin is dependent upon the physician group or practice joined. In addition, medications used could be institution dependent versus based on provider choice. Pediatricians sedate a variety of patients but the patients tend to be younger, predominately ASA class I or II, non-emergency and undergoing non-painful procedures compared to patients sedated by non-pediatrician providers. The patient demographics, medications used, diagnoses, complications, and procedures involved vary between the groups significantly.