Sedation in the emergency department: A complex and multifactorial challenge

Robert M. Kennedy

doi:10.1007/978-1-4939-1390-9_19

Sedation in the emergency department: A complex and multifactorial challenge

Robert M. Kennedy

Division of Emergency Medicine

Research output: Chapter in Book/Report/Conference proceeding › Chapter › peer-review

3 Scopus citations

Abstract

Safe and effective management of procedure- related pain and anxiety in the emergency department (ED) has become expected. It facilitates controlled accomplishment of therapeutic and diagnostic procedures, reduces psychological trauma and its sequelae, reduces healthcare provider and parental distress, and improves parental acceptance of rendered care. Many advances in procedural sedation and analgesia (PSA) for nonelective procedures in non-fasted patients in the ED have occurred over the past 20 years as a result of intense interest in this concept and the development of general and pediatric emergency medicine specialties, for whom PSA is now considered core training. This chapter reviews some of the PSA techniques shown to safely and effectively decrease Childrens pain and anxiety associated with procedures in the ED. Since pain and anxiety are frequently indistinguishable, the combination will often be referred to as distress.

Original language	English
Title of host publication	Pediatric Sedation Outside of the Operating Room
Subtitle of host publication	A Multispecialty International Collaboration, Second Edition
Publisher	Springer New York
Pages	367-422
Number of pages	56
ISBN (Electronic)	9781493913909
ISBN (Print)	9781493913893
DOIs	https://doi.org/10.1007/978-1-4939-1390-9_19
State	Published - Jan 1 2015

Keywords

Adverse events
American College of Emergency Physicians
American Society of Anesthesiologists (ASA)
Anxiety
Atropine
Barbiturates
Capnography
Chloral hydrate
Codeine
Deep sedation
Dexamethasone (Decadron)
Diazepam
Diphenhydramine (Benadryl)
Emergency department
Emesis
Etomidate
Eutectic Mixture of Local Anesthetics (EMLA)
Fentanyl
Flumazenil
Flumazenil
Fospropofol
Gamma-aminobutyric acid (GABA)
Glycopyrrolate
Ketamine
Ketamine
Ketofol
Laryngospasm
Lidocaine
Local anesthesia
Lorazepam
Mallampati
Meperidine (Demerol)
Methohexital (Brevital)
Metoclopramide (Reglan)
Midazolam (Versed)
Moderate sedation
Morphine
Motion
Naloxone (Narcan)
Naloxone (Narcan)
Nil per os (NPO)
Nitrous oxide
Ondansetron (Zofran)
Ondansetron (Zofran)
Oxycodone
Pain
Pentobarbital (Nembutal)
Procedural sedation and analgesia (PSA)
Propofol
Psychological intervention
Pulmonary aspiration
Remifentanil
S-ketamine
Scopolamine
Succinylcholine
Sufentanil
Upper airway obstruction

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10.1007/978-1-4939-1390-9_19

Cite this

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abstract = "Safe and effective management of procedure- related pain and anxiety in the emergency department (ED) has become expected. It facilitates controlled accomplishment of therapeutic and diagnostic procedures, reduces psychological trauma and its sequelae, reduces healthcare provider and parental distress, and improves parental acceptance of rendered care. Many advances in procedural sedation and analgesia (PSA) for nonelective procedures in non-fasted patients in the ED have occurred over the past 20 years as a result of intense interest in this concept and the development of general and pediatric emergency medicine specialties, for whom PSA is now considered core training. This chapter reviews some of the PSA techniques shown to safely and effectively decrease Childrens pain and anxiety associated with procedures in the ED. Since pain and anxiety are frequently indistinguishable, the combination will often be referred to as distress.",

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KW - Barbiturates

KW - Capnography

KW - Chloral hydrate

KW - Codeine

KW - Deep sedation

KW - Dexamethasone (Decadron)

KW - Diazepam

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KW - Etomidate

KW - Eutectic Mixture of Local Anesthetics (EMLA)

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KW - Lorazepam

KW - Mallampati

KW - Meperidine (Demerol)

KW - Methohexital (Brevital)

KW - Metoclopramide (Reglan)

KW - Midazolam (Versed)

KW - Moderate sedation

KW - Morphine

KW - Motion

KW - Naloxone (Narcan)

KW - Nil per os (NPO)

KW - Nitrous oxide

KW - Ondansetron (Zofran)

KW - Oxycodone

KW - Pain

KW - Pentobarbital (Nembutal)

KW - Procedural sedation and analgesia (PSA)

KW - Propofol

KW - Psychological intervention

KW - Pulmonary aspiration

KW - Remifentanil

KW - S-ketamine

KW - Scopolamine

KW - Succinylcholine

KW - Sufentanil

KW - Upper airway obstruction

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SN - 9781493913893

SP - 367

EP - 422

BT - Pediatric Sedation Outside of the Operating Room

PB - Springer New York

ER -

Sedation in the emergency department: A complex and multifactorial challenge

Abstract

Keywords

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