Background: The elderly are perceived as a high-risk group for procedural sedation. Concern exists regarding the safety of sedation of this patient group by emergency physicians, particularly when using propofol. Methods: We analysed prospectively collected data on patients aged 75 yr or older undergoing sedation between October 2006 and March 2017 in the emergency department of a single centre. We used the World Society of Intravenous Anaesthesia International Sedation Task Force adverse event tool, stratifying identified adverse events according to consensus agreement. Results: Of 740 consecutive patients (median age 84 yr), 571 patients received propofol, 142 morphine and midazolam, and 27 other agents. We identified 19 sentinel events: 2 cases of hypoxaemia, 10 of apnoea (without hypoxaemia), 5 of hypotension, and 2 of both hypoxaemia and hypotension. We also identified 30 moderate, 41 minor, and 7 minimal risk adverse events. There were no adverse outcomes. Conclusions: We observed safe sedation practice in this high-risk group of patients. A sentinel adverse event rate of 2.6% including a hypoxaemia rate of 0.5% with no adverse outcomes sets a benchmark for sedation of the elderly.
Conclusions Significant events can negatively impact on trainees' wellbeing; affecting them both personally and professionally. This can have long term implications on trainees' mental health, as well as workforce retention. It is therefore essential we ask 'are you ok?' If delivered appropriately, the debrief process can provide us with this opportunity ensuring the well-being of our trainees.
more commonly older, and from ethnic minority groups. However, the age and ethnic profile of all-cause child mortality during lockdown appeared similar to deaths pre-lockdown and in 2019. We also found little evidence of over-representation of children with underlying health conditions among children who died with the virus. More specifically, we noted:
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