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Procedural Sedation

Procedural Sedation is a topic covered in the 5-Minute Emergency Consult.

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Basics

Administration of agents with or without analgesia to induce a state that allows diagnostic and therapeutic procedures to be performed successfully without significant pain and/or anxiety while maintaining cardiorespiratory function.
Preparation
  • Obtain consent
  • Equipment
    • Breathing masks, bag-valve ventilation device, oropharyngeal and nasal airways, laryngoscopes, endotracheal tubes, and stylets appropriate for size of patient
    • Defibrillator/automated external defibrillator
    • Suction
    • Emergency cart with all available medications if resuscitation needed
    • Flumazenil and naloxone
  • Apply cardiorespiratory monitor, pulse oximeter, and BP monitor
  • Gather medicines that will be used in procedure, label (preferably color-coded) syringes, and place at bedside.
  • Apply oxygen delivery device (cannula or mask) and keep oxygen saturation >95%.
Sedation Agents and Techniques
  • Can be administered by various means
  • Administer local or regional anesthesia if applicable.
  • Perform the procedure.
  • Closely observe and monitor patient during entire course of procedure as well as the recovery period afterward.
  • Monitor patient until awake, alert, and back to baseline function.

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Citation

Rosen, Peter, et al., editors. "Procedural Sedation." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307200/all/Procedural_Sedation.
Procedural Sedation. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307200/all/Procedural_Sedation. Accessed April 24, 2019.
Procedural Sedation. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307200/all/Procedural_Sedation
Procedural Sedation [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307200/all/Procedural_Sedation.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Procedural Sedation ID - 307200 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307200/all/Procedural_Sedation PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -