Factors associated with failure to successfully complete a procedure during emergency department sedation

Taylor, David; Bell, Anthony; MacBean, Catherine E; Huynh, Truc T.; Thom, Ogilvie; Augello, Michael; Millar, Robert; Day, Robert; Williams, Aled; Ritchie, Peter; Pasco, J. A.

doi:10.1111/j.1742-6723.2011.01420.x

Cited by 12 publications

(13 citation statements)

References 11 publications

(35 reference statements)

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“…19 Amnesia We found amnesia in 83% of patients, less than we would have expected. Likely this is due to the lower sedation levels in our cohort (ASA sedation level minimal 16%, moderate 47%), as we found lower sedation levels to be associated with less amnesia.…”

Section: Adverse Events Ratecontrasting

confidence: 60%

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Procedural sedation in the emergency department by Dutch emergency physicians: a prospective multicentre observational study of 1711 adults

et al. 2016

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ObjectiveTo describe our experience performing ED procedural sedation in a country where emergency medicine (EM) is a relatively new specialty.MethodsThis is a prospective observational study of adult patients undergoing procedural sedation by emergency physicians (EPs) or EM residents in eight hospitals in the Netherlands. Data were collected on a standardised form, including patient characteristics, sedative and analgesic used, procedural success, adverse events (classified according to World SIVA) and rescue interventions.Results1711 adult cases were included from 2006 to 2013. Propofol, midazolam and esketamine (S+ enantiomer of ketamine) were the most used sedatives (63%, 29% and 8%). We had adverse event data on all patients. The overall adverse event rate was 11%, mostly hypoxia or apnoea. There was no difference in adverse event rate between EPs and EM residents. However, there was a significantly higher success rate of the procedure when EPs did the procedural sedation (92% vs 84%). No moderate (unplanned hospital admission or escalation of care) or sentinel SIVA outcomes occurred (pulmonary aspiration syndrome, death or permanent neurological deficit).ConclusionAdverse events during procedural sedation occurred in 11% of patients. There were no moderate or sentinel outcomes. All events could be managed by the sedating physician. In a country where EM is a relatively new specialty, procedural sedation appears to be safe when performed by EPs or trained EM residents and has comparable adverse event rates to international studies.

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Section: Adverse Events Ratecontrasting

confidence: 60%

“…Data were analysed with SPSS V. 19. Continuous variables were presented as means (95% CIs) or medians (IQR; min-max) depending on normal distribution of the data.…”

Section: Discussionmentioning

confidence: 99%

Procedural sedation in the emergency department by Dutch emergency physicians: a prospective multicentre observational study of 1711 adults

et al. 2016

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“…This is the largest multi‐centre observational study of ED PSA practice in Australia to date. Accordingly, the results will inform procedural sedation practice when combined with the adverse event 28 and failed procedure data 29 …”

Section: Discussionmentioning

confidence: 99%

“…The present study aimed to determine the nature of contemporary procedural sedation practice in Australian EDs. The results, in conjunction with other components of the project including adverse events 28 and failed procedures, 29 will inform the development of Australian PSA guidelines.…”

Section: Introductionmentioning

confidence: 94%

Procedural sedation practices in Australian Emergency Departments

Bell

Taylor

MacBean

et al. 2011

Emerg Medicine Australasia

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“…Some of their conclusions were that Propofol had the highest failure rate of all sedative drugs used as a single sedative agent (5.9%, 95% CI 4.6-7.6) [108]; increased body weight and specific procedures, such as hip reduction, were associated with significantly higher failure rates [108]; and that increasing age and level of sedation, pre-medication with fentanyl, and sedation with Propofol, midazolam or fentanyl were risk factors for an airway event (P < 0.05) [80]. …”

Section: Knowledge Extraction Proceduresmentioning

confidence: 99%

Data linkage for querying heterogeneous databases

Gollapalli¹

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Data Linkage is an important step that can provide valuable insights for evidence-based decision making, especially for crucial events. Performing sensible queries across heterogeneous databases containing millions of records is a complex task that requires a complete understanding of each contributing database's schema to define the structure of its information. The key aim is to approximate the structure and content of the induced data into a concise synopsis in order to extract and link meaningful facts. Current techniques primarily focus on performing pair-wise attribute matching and pay little attention in discovering direct and weighted cluster correlations for linking semantic equivalent datasets. We identify such problems as four major research issues in Data Linkage: associated costs in pair-wise matching, record matching overheads, semantic flow of information restrictions, and single order classification limitations.In this doctorial dissertation, we introduce a new multi-faceted classification technique for performing structural analysis on knowledge domain clusters, using a novel Ontology Guided Data Linkage (OGDL) framework. In order to support self-organization of contributing databases through the discovery of structural dependencies, we introduce a series of algorithms for performing multi-level exploitation of ontological domain knowledge relating to tables, attributes and tuples. These techniques are of great help for automating the discovery of schema structures across multiple databases, based on the use of direct and weighted correlations between different ontological concepts, using a novel h-gram (hash gram) record matching technique for concept clustering and cluster mapping. Moreover, through a set of accuracy, performance and scalability experimental tests run on real-world datasets, we demonstrate the feasibility of our OGDL algorithms and show that our framework runs in polynomial time and performs well in practice.Data Linkage is an important enabling technology in eHealth as linked data is a cost effective approach towards advancing research outcomes into health policies, detect any adverse drug reactions, reduce costs, and uncover any non-practices within the health system. Hence, to illustrate the efficiency and effectiveness of OGDL in real-world applications, we comprehensively used clinical risk management domain as our practical example. For this reason, we further extended our OGDL framework and introduced a composite clinical risk management success indicator data linkage, which consists of clinical risk factors combined with clinical resource and intervention factors that have shown to be asii sociated with good and safe patient outcomes and with quality health care. The aim is to introduce a novel primitive upper ontology for semantic interoperability of health data and subsequent clinical risk management, and use it to map patient case data to reason about problems and solutions. Our experiments are performed on the Australian emergency medicine clinical trial da...

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Factors associated with failure to successfully complete a procedure during emergency department sedation

Cited by 12 publications

References 11 publications

Procedural sedation in the emergency department by Dutch emergency physicians: a prospective multicentre observational study of 1711 adults

Procedural sedation in the emergency department by Dutch emergency physicians: a prospective multicentre observational study of 1711 adults

Procedural sedation practices in Australian Emergency Departments

Data linkage for querying heterogeneous databases

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