Fasting and emergency department procedural sedation and analgesia: a consensus-based clinical practice advisory.
نویسندگان
چکیده
Emergency physicians frequently administer procedural sedation and analgesia to nonfasted patients; however, they currently have no specific guidelines to aid them in preprocedural risk stratification. We assembled a committee of leading emergency physician sedation researchers to develop a consensus-based clinical practice advisory for this purpose. Our goal was to create a tool to permit emergency physicians to identify prudent limits of sedation depth and timing in light of fasting status and individual patient risk factors. The advisory is not intended to assert a legal standard of practice or absolute requirement. It is expected that emergency physicians will at times appropriately deviate from it according to individualized judgment and unique clinical circumstances.
منابع مشابه
Review of studies and guidelines on fasting and procedural sedation at the emergency department.
AIM Procedural sedation and analgesia allows urgent procedures to be performed safely by preserving patients' airway reflexes. Fasting, which is required before deeper levels of sedation, and where the airway reflexes are not preserved, is difficult to impose in emergencies. This paper aims to synthesise evidence on the need for pre-procedure fasting to minimise aspiration among adults undergoi...
متن کاملClinical policy: procedural sedation and analgesia in the emergency department.
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.1 A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions: (1) In patients undergoing procedural sedatio...
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We present an evidence-based clinical practice advisory for the administration of propofol for emergency department procedural sedation. We critically discuss indications, contraindications, personnel and monitoring requirements, dosing, coadministered medications, and patient recovery from propofol. Future research questions are considered.
متن کاملPulmonary aspiration risk during emergency department procedural sedation--an examination of the role of fasting and sedation depth.
The assessment of pre-procedure fasting and control of sedation depth are prominent elements of widely disseminated procedural sedation guidelines and of the Joint Commission on Accreditation of Healthcare Organizations' standards. Both exist primarily to minimize the risk of pulmonary aspiration of gastric contents. This paper critically examines the literature on pre-procedure fasting and con...
متن کاملProcedural sedation and analgesia in the emergency department.
PURPOSE OF REVIEW Procedural sedation and analgesia is frequently administered outside of the operating room in emergency departments (EDs) and ICUs. Evidence was sought concerning patients' safety in the ED. RECENT FINDINGS Procedural sedation, when administered in the ED by trained personnel, is safe. Extensive literature demonstrates that propofol, ketamine, midazalam, and fentanyl are app...
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ورودعنوان ژورنال:
- Annals of emergency medicine
دوره 49 4 شماره
صفحات -
تاریخ انتشار 2007