Procedural sedation for adult patients: an overview

Blayney, M R

doi:10.1093/bjaceaccp/mks016

Cited by 33 publications

(19 citation statements)

References 4 publications

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“…For sedation, the intravenous route should be used in preference to intramuscular or other routes . Titration of small doses of sedation are carried out to achieve the desired effect (e.g. 1–2 mg increments of midazolam).…”

Section: Pre‐anaesthesia Sedationmentioning

confidence: 99%

“…Where intravascular access is difficult (e.g. in combative patients or those with a history of intravenous drug abuse), it may be necessary to sedate the patient using the intramuscular route . As titration is not possible, a drug such as ketamine that will not cause respiratory or cardiovascular collapse should be used.…”

Section: When To Consider Intramuscular Sedationmentioning

confidence: 99%

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AAGBI: Safer pre-hospital anaesthesia 2017

et al. 2017

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SummaryPre‐hospital emergency anaesthesia with oral tracheal intubation is the technique of choice for trauma patients who cannot maintain their airway or achieve adequate ventilation. It should be carried out as soon as safely possible, and performed to the same standards as in‐hospital emergency anaesthesia. It should only be conducted within organisations with comprehensive clinical governance arrangements. Techniques should be straightforward, reproducible, as simple as possible and supported by the use of checklists. Monitoring and equipment should meet in‐hospital anaesthesia standards. Practitioners need to be competent in the provision of in‐hospital emergency anaesthesia and have supervised pre‐hospital experience before carrying out pre‐hospital emergency anaesthesia. Training programmes allowing the safe delivery of pre‐hospital emergency anaesthesia by non‐physicians do not currently exist in the UK. Where pre‐hospital emergency anaesthesia skills are not available, oxygenation and ventilation should be maintained with the use of second‐generation supraglottic airways in patients without airway reflexes, or basic airway manoeuvres and basic airway adjuncts in patients with intact airway reflexes.

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Section: Pre‐anaesthesia Sedationmentioning

confidence: 99%

Section: When To Consider Intramuscular Sedationmentioning

confidence: 99%

AAGBI: Safer pre-hospital anaesthesia 2017

et al. 2017

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“…The likelihood of adverse events increases if this is not managed accordingly, and effectively. Thus, the increasing depth of sedation should therefore be accompanied by an escalation in the level of competency required to ensure safe sedation practice 25 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of fasting and non‐fasting patients receiving intravenous (IV) sedation

Besi¹,

Besi

Lees³

et al. 2017

Oral Surgery

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Aim In 2015 the Intercollegiate Advisory Committee for Sedation in Dentistry published a national standard for the provision of conscious sedation in dentistry. This document highlighted the need for justification of the decision not to fast patients prior to administration of IV sedation. The aim of this case control study was to compare a fasting (F) and non‐fasting (NF) group of patients undergoing oral surgery procedures under IV sedation, and to assess for sedation related complications in both groups. Material and methods A total of 228 patients were analysed, with 114 patients in each group. Results Mean age was 33 years for the F group and 30.2 years for the NF group. The average midazolam dose was 5.11 mg for the F group and 5.72 for the NF group (pa = 0.03). The mean recovery time was: 38.53 min for the F group and 36.57 min for the NF group (pa = 0.14). Extra measures required included: supplemental oxygen for 5 patients in the F group and 6 patients in the NF group, Oral glucose was given during the recovery period to 6 patients in the F group. 1 patient in the F group was unable to be cannulated. Conclusions Practicing minimal to moderate sedation in ASA 1 and 2 non‐fasting patients is safe and in our study appears to give less complications than the fasting patients.

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“…They must be able to provide advanced airway management and to ''rescue'' patients who become more deeply sedated than intended and develop respiratory depression or apnea. 13 Failure to respond quickly and appropriately in such circumstances may result in life-threatening complications, such as hypoxic brain injury, pulmonary aspiration of gastric contents, and cardiac arrest.…”

Section: Management Of Sedation and Patient Monitoringmentioning

confidence: 99%

“…Ils doivent être capables d'assurer une gestion avancée des voies respiratoires et de « sauver » les patients dont la sédation devient plus profonde que prévu et développe une dépression respiratoire ou des apnées. 13 L'absence de réponse rapide et appropriée à de telles circonstances peut déboucher sur des complications engageant le pronostic vital tel qu'une lésion hypoxique du cerveau, l'aspiration pulmonaire du contenu gastrique et un arrêt cardiaque.…”

Section: Gestion De La Sédation Et Surveillance Des Patientsunclassified