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Chapter 17 - Sedation in the emergency department

Published online by Cambridge University Press:  05 March 2012

By
Heikki E. Nikkanen
Edited by
Richard D. Urman  and
Alan D. Kaye
Richard D. Urman
Affiliation:
Brigham and Women's Hospital/Harvard Medical School
Alan D. Kaye
Affiliation:
LSU School of Medicine, New Orleans
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Summary

The demands made on a modern emergency department (ED) are such that having an internal capacity to provide a range of procedural sedation is essential to its functioning. Emergency physicians (EPs) have advanced airway management and resuscitation training to manage complications arising from sedation. A good working relationship between the department of anesthesia and the ED is thus of great importance in creating and maintaining a procedural sedation program. Both moderate and deep sedation have been shown to be safe tools in the hands of EP. Striking a balance between safety and prompt treatment is a prime consideration for the EP. The drug and dose should be primarily chosen as a function of the sedation assessment. For many ED sedations, propofol is chosen for its effects and short duration of action. The chapter also presents a few representative cases describing procedural sedation management of patients in the ED setting.

Keywords

procedure-related risk factorsrespiratory system complicationspatient-related risk factorspreoperative risk assessmentmoderate sedationsedation scoring scalesgastroenterological complicationscardiovascular system complicationsdeep sedation
Type
Chapter
Information
Moderate and Deep Sedation in Clinical Practice , pp. 209 - 217
Publisher: Cambridge University Press
Print publication year: 2012

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