Procedural Sedation & Analgesia
Episode description
In this episode, Sam Ashoo, MD interviews Prayag Mehta, MD and Joshua Kern, MD – two of the authors of the June, 2022 EMP article on Procedural Sedation and Analgesia in the Emergency Department. Listen to the discussion to hear more about the emergency medicine approach to sedation in adults and pediatrics !
Procedural Sedation and Analgesia in the Emergency Department
EMplify – June 2022
Episode Outline:
1.Procedural sedation and analgesia (PSA): terminology
2.Levels of sedation
- Minimal
- Moderate
- Deep
- General anesthesia
3.Prehospital care
4.ED care: patient assessment
- ASA class system
- Complications
- Equipment needed (Table 1)
- Larson maneuver (Figure 2)
5.Procedural technique
- Current ACEP and AAP recommendations
- Data for 1- or 2-physician sedation
6.Preprocedural fasting
- Do we even need to consider this in PSA?
7.Capnography
8.Oxygen supplementation
9.Preprocedural opioids
10.Preprocedural sedatives
11.Anticholinergics
12.Antiemetics
13.Treatment (Table 2)
- Fentanyl
- Remifentanil
- Midazolam
- Nitrous oxide
- Propofol
- Ketamine
- Ketofol
- Etomidate
14.Reversal agents
- Naloxone
- Flumazenil
15.Special populations
- Pediatrics
- Pregnancy
- Geriatrics
16.Cutting edge
- Dexmedetomidine