Journal ArticleDOI
Capnography Monitoring During Procedural Sedation and Analgesia
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TLDR
Capnography indicates partial pressure of end‐tidal carbon dioxide and provides information regarding airway integrity and patterns of ventilation compromise, and may provide an additional layer of safety, reducing risk of respiratory compromise in patients receiving procedural sedation.Abstract:
Procedural sedation is used to alleviate pain and anxiety associated with diagnostic procedures in the acute care setting. Although commonly used, procedural sedation is not without risk. Key to reducing this risk is early identification of risk factors through presedation screening and monitoring during the procedure. Electrocardiogram, respiratory rate, blood pressure, and pulse oximetry commonly are monitored. These parameters do not reliably identify airway and ventilation compromise. Capnography measures exhaled carbon dioxide and provides early identification of airway obstruction and hypoventilation. Capnography is useful in patients receiving supplemental oxygen. In these patients, oxygen desaturation reported by pulse oximetry may lag during episodes of respiratory depression and apnea. Capnography indicates partial pressure of end-tidal carbon dioxide and provides information regarding airway integrity and patterns of ventilation compromise. Implementation of this technology may provide an additional layer of safety, reducing risk of respiratory compromise in patients receiving procedural sedation.read more
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References
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Journal ArticleDOI
Controlled sedation with alphaxalone-alphadolone
TL;DR: Alphaxalone-alphadolone (Althesin), diluted and administered as a controlled infusion, was used as a sedative for 30 patients in an intensive therapy unit and provided “light sleep,” allowed rapid variation in the level of sedation, and enabled repeated assessment of the central nervous system.
Journal ArticleDOI
Validity and reliability of the Observer's Assessment of Alertness/Sedation Scale: study with intravenous midazolam.
Doris A. Chernik,Dennis Gillings,Harriet Laine,Judith Hendler,Jonathan M. Silver,Arnold B. Davidson,Elias M. Schwam,Judith L. Siegel +7 more
TL;DR: The Observer's Assessment of Alertness/Sedation (OAA/S) Scale was developed to measure the level of alertness in subjects who are sedated and was reliable and valid as measured by high correlation between the two raters and high correlations between the OAA/s Scale and two of the three standard tests used in this study.
Journal ArticleDOI
Clinical policy: procedural sedation and analgesia in the emergency department.
Steven A. Godwin,John H. Burton,Charles J. Gerardo,Benjamin W. Hatten,Sharon E. Mace,Scott M. Silvers,Francis M. Fesmire +6 more
TL;DR: This clinical policy from the American College of Emergency Physicians is the revision of a 2005 clinical policy evaluating critical questions related to procedural sedation in the emergency department.
Journal ArticleDOI
Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update
Charles J. Coté,Stephen Wilson +1 more
TL;DR: The safe sedation of children for procedures requires a systematic approach that includes no administration of sedating medication without the safety net of medical supervision and careful presedation evaluation for underlying medical or surgical conditions that place the child at increased risk from sedating medications.