Advertisement

 

 

Procedural sedation in the emergency department by Dutch emergency physicians: a prospective multicentre observational study of 1711 adults.

Procedural sedation in the emergency department by Dutch emergency physicians: a prospective multicentre observational study of 1711 adults.
Author Information (click to view)

Smits GJ, Kuypers MI, Mignot LA, Reijners EP, Oskam E, Van Doorn K, Thijssen WA, Korsten EH,


Smits GJ, Kuypers MI, Mignot LA, Reijners EP, Oskam E, Van Doorn K, Thijssen WA, Korsten EH, (click to view)

Smits GJ, Kuypers MI, Mignot LA, Reijners EP, Oskam E, Van Doorn K, Thijssen WA, Korsten EH,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Emergency medicine journal : EMJ 2016 10 2134(4) 237-242 doi 10.1136/emermed-2016-205767
Abstract
OBJECTIVE
To describe our experience performing ED procedural sedation in a country where emergency medicine (EM) is a relatively new specialty.

METHODS
This is a prospective observational study of adult patients undergoing procedural sedation by emergency physicians (EPs) or EM residents in eight hospitals in the Netherlands. Data were collected on a standardised form, including patient characteristics, sedative and analgesic used, procedural success, adverse events (classified according to World SIVA) and rescue interventions.

RESULTS
1711 adult cases were included from 2006 to 2013. Propofol, midazolam and esketamine (S+ enantiomer of ketamine) were the most used sedatives (63%, 29% and 8%). We had adverse event data on all patients. The overall adverse event rate was 11%, mostly hypoxia or apnoea. There was no difference in adverse event rate between EPs and EM residents. However, there was a significantly higher success rate of the procedure when EPs did the procedural sedation (92% vs 84%). No moderate (unplanned hospital admission or escalation of care) or sentinel SIVA outcomes occurred (pulmonary aspiration syndrome, death or permanent neurological deficit).

CONCLUSION
Adverse events during procedural sedation occurred in 11% of patients. There were no moderate or sentinel outcomes. All events could be managed by the sedating physician. In a country where EM is a relatively new specialty, procedural sedation appears to be safe when performed by EPs or trained EM residents and has comparable adverse event rates to international studies.

Submit a Comment

Your email address will not be published. Required fields are marked *

10 + 15 =

[ HIDE/SHOW ]