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4 results

  • Chapter 21 - Procedural Sedation in the Emergency Department

  • Edited by Richard D. Urman, Ohio State University, Alan David Kaye, Louisiana State University School of Medicine
  • Book:
    Moderate and Deep Sedation in Clinical Practice
    Published online:
    12 December 2024
    Print publication:
    19 December 2024, pp 263-273

  • 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. Patients arrive at every hour of the day, with pathology that may require sedation for diagnosis or treatment. The requirement for urgent action is greater than in an outpatient office or clinic, where cases are typically planned. Patients in the ED may be critically ill, or have a threat to an organ or limb that must be dealt with rapidly. Imposing on colleagues from the department of anesthesia to provide sedation for these patients is unnecessary and logistically difficult, given the after-hours and unplanned nature of these cases. Emergency physicians with training and board certification in emergency medicine have the skills to recognize these situations, and to assess the risks and benefits of procedural sedation in caring for these patients. In addition, the emergency physician has advanced airway management and resuscitation training to manage complications arising from sedation [1, 2].

  • Chapter 17 - Sedation in the emergency department

  • Edited by Richard D. Urman, Alan D. Kaye
  • Book:
    Moderate and Deep Sedation in Clinical Practice
    Published online:
    05 March 2012
    Print publication:
    09 February 2012, pp 209-217

  • Summary

    Sedation is described as a continuum, and it is often categorized according to the patient's level of consciousness as minimal, moderate, and deep sedation. Intravenous sedation can potentially cause numerous complications. The clinicians should therefore have a thorough knowledge of these possible complications and understand their management strategies. There are several scoring systems used to document the patient's mental status and depth of sedation, such as the Richmond Agitation-Sedation Scale (RASS) and the Inova Health System Sedation Scale (ISS). Prevention of complications starts with a thorough pre-procedural patient assessment. This chapter discusses, among other things, some of the patient-related risk factors and procedure-related risk factors. Among all the complications induced by intravenous sedation, respiratory complications are the most common. Moderate and deep sedation may have varying degrees of depressive effects on cardiovascular function, depending on the patient's physiological status and the dosage of sedatives administered.