scholarly journals Procedural Sedation and Analgesia in Adults - new trends in patients safety

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Mădălina Duţu ◽  
Robert Ivascu ◽  
Darius Morlova ◽  
Alina Stanca ◽  
Dan Corneci ◽  
...  
Keyword(s):  
Side Effects ◽  
Procedural Sedation ◽  
Moderate Sedation ◽  
Procedural Sedation And Analgesia ◽  
Sedation And Analgesia ◽  
American Society

AbstractSedation and analgesia may be need­ed for many interventional or diagnostic proce­dures, whose number has grown exponentially lately. The American Society of Anesthesiolo­gists introduced the term “procedural sedation and analgesia” (PSA) and clarified the termi­nology, moderate sedation and Monitored An­esthesia Care. This review tries to present a nondissociative sedation classification, follow­ing ASA guidelines as well as pre-procedural assessment and preparation, in order to choose the appropriate type and level of sedation, pa­tient monitoring and agents, which are most commonly used for sedation and/or analgesia, along with their possible side effects. The paper also lists the possible complications associated with PSA and a few specific particularities of procedural sedation.

scholarly journals Procedural Sedation and Analgesia in Adults - new trends in patients safety

2019 ◽  
Vol 2 (1) ◽  
pp. 11-22
Author(s):  
Mădălina Duţu ◽  
Robert Ivascu ◽  
Darius Morlova ◽  
Alina Stanca ◽  
Dan Corneci ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Diagnostic Procedures ◽  
Procedural Sedation ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
Moderate Sedation ◽  
Procedural Sedation And Analgesia ◽  
Sedation And Analgesia ◽  
American Society ◽  
American Society Of Anesthesiologists

AbstractSedation and analgesia may be needed for many interventional or diagnostic procedures, whose number has grown exponentially lately. The American Society of Anesthesiologists introduced the term “procedural sedation and analgesia” (PSA) and clarified the terminology, moderate sedation and Monitored Anesthesia Care. This review tries to present a nondissociative sedation classification, follow ing ASA guidelines as well as pre-procedural assessment and preparation, in order to choose the appropriate type and level of sedation, patient monitoring and agents, which are most commonly used for sedation and/or analgesia, along with their possible side effects. The paper also lists the possible complications associated with PSA and a few specific particularities of procedural sedation.

Pediatric Procedural Sedation

2017 ◽  
Author(s):  
Sara W. Nelson ◽  
J. Calvin Simmons
Keyword(s):  
Emergency Department ◽  
Pediatric Population ◽  
Parent Satisfaction ◽  
Well Being ◽  
Procedural Sedation ◽  
Negative Consequences ◽  
Efficient Manner ◽  
Procedural Sedation And Analgesia ◽  
Sedation And Analgesia ◽  
American Society

Children present to the emergency department with painful conditions or conditions that require diagnostic or therapeutic procedures every day. As emergency physicians, we need to have the skills to manage our patients’ pain and anxiety in a safe and efficient manner. Appropriately managing pain and anxiety facilitates medical interventions, decreases patients’ suffering, improves patient and parent satisfaction, and improves the quality of care. Conversely, failure to adequately provide analgesia and sedation can have negative consequences for pediatric patients. In the pediatric population, inadequate pain control not only causes immediate harm and fear but can also worsen the reaction to future medical care and potentially affect the child’s long-term psychological well-being. This review provides an overview of pediatric procedural sedation, as well as the pathophysiology and practice. Figures show the sedation continuum with associated physiologic responses, oxyhemoglobin desaturation during apnea for various types of patients, and examples of capnography waveforms in procedural sedation and analgesia (PSA). Tables list potential indications for pediatric PSA in the emergency department, American Society of Anesthesiologists’ classifications, drugs and pharmacokinetics of common agents used in PSA, focused history and physical examination for patients undergoing PSA, SOAPME (Suction, Oxygen, Airway, Pharmacy, Monitors, Equipment) acronym for PSA equipment, and suggested monitoring for PSA pre- and postprocedure. This review contains 3 highly rendered figures, 6 tables, and 41 references. Key words: pediatric analgesia; pediatric pain; pediatric procedural sedation; pediatric sedation; procedural pain relief; procedural sedation and analgesia

Society Guidelines

2018 ◽  
pp. 382-391
Author(s):  
Urmila Tirodker
Keyword(s):  
Procedural Sedation ◽  
Advanced Practice ◽  
Patient Evaluation ◽  
Procedural Sedation And Analgesia ◽  
American Academy Of Pediatrics ◽  
Enhance Patient Safety ◽  
Sedation And Analgesia ◽  
American Society ◽  
Guidelines And Standards ◽  
American Society Of Anesthesiologists

In the past several decades the practice of procedural sedation and analgesia has evolved into a distinct skill set and a service that has rapidly grown in terms of indications, need, practitioner types, and practice settings. The scope of non-anesthesiology sedation providers includes but is not limited to intensivists, emergency medicine physicians, hospitalists, dentists, gastroenterologists, pulmonologists, cardiologists, advanced practice providers, and nursing. Several subspecialty societies and regulatory institutions have published and revised guidelines and standards to enhance patient safety by standardizing various aspects related to patient evaluation, personnel, monitoring, and management of procedural sedation and analgesia and its recovery. The American Academy of Pediatrics, American Society of Anesthesiologists, and the American College of Emergency Physicians are the groups that have published the most widely disseminated, comprehensive guidelines. This chapter gives an overview of these societies’ guidelines.

scholarly journals Does the sedation regimen affect adverse events during procedural sedation and analgesia in injection drug users?

CJEM ◽  
2013 ◽  
Vol 15 (05) ◽  
pp. 279-288 ◽  
Author(s):  
Frank Xavier Scheuermeyer ◽  
Gary Andolfatto ◽  
Hong Qian ◽  
Eric Grafstein
Keyword(s):  
Adverse Events ◽  
Injection Drug Users ◽  
Drug Users ◽  
Vital Signs ◽  
Injection Drug ◽  
Procedural Sedation ◽  
Secondary Outcome ◽  
Procedural Sedation And Analgesia ◽  
Pearson Coefficient ◽  
Sedation And Analgesia

ABSTRACT Objectives: Injection drug users (IDUs) often undergo procedural sedation and analgesia (PSA) as part of emergency department (ED) treatment. We compared adverse events (AEs) using a variety of sedation regimens. Methods: This was a retrospective analysis of a PSA safety audit in two urban EDs. Consecutive self-reported IDUs were identified, and structured data describing comorbidities, vital signs, sedation regimens (propofol [P], propofol-fentanyl [PF], fentanyl-midazolam [FM], ketofol [1:1 ketamine:propofol, KF], and ketamine-propofol [KP]) and AEs were collected. The primary outcome was the proportion of patients in each sedation group having an AE; the secondary outcome was the proportion of patients having a cardiovascular or respiratory AE. Results: Data were collected on 276 IDUs (78 P, 82 PF, 65 FM, 25 KF, and 26 KP), and 18 patients had AEs (6.5%, 95% CI 4.0–10.3). The AE rates were 0.0%, 8.5%, 9.2%, 12.0%, and 7.6%, respectively, with propofol having a significantly lower rate (Pearson coefficient 14.9, p = 0.007). The cardiovascular/respiratory AE rates were significantly different as well, with P, KP, and KF having the lowest rates (Pearson coefficient 13.3, p = 0.01). Conclusions: For IDU PSA, the overall AE rate was 6.5%, and propofol appeared to have a significantly lower rate.

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