July 17, 2017

Episode 106.0 – Procedural Sedation and Analgesia II

7 minutes

This week we drop into some of the nitty gritty on PSA including preparation and patient assessment as well as discuss some common pitfalls.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_106_0_Final_Cut.m4a

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Tags: Pitfalls, Procedural Sedation, PSA

Show Notes

Take Home Points

Always perform a full pre-PSA evaluation including an airway assessment. Time of last meal shouldn’t delay your sedation based on the best available evidence.

Always do a complete setup including consideration of different agents, dosage calculations, preparation of airway equipment and reversal agents.

PSA serious adverse events are rare but you still must be prepared for them. Careful agent selection and dosing can help prevent issues but, know your outs.

If apnea develops, do some basic maneuvers before you reach for the BVM or laryngoscope. Remember OOPS as in “oops, my patient went apneic.” Oxygen on, pull the mandible forward and sit the patient up. This fixes most issues

Show Notes

Core EM: Procedural Sedation and Analgesia Resources

EM Updates:Emergency Department Procedural Sedation Checklist v2

REBEL EM: Complications of Procedural Sedation

Bellolio MF et al. Incidence of adverse events in adults undergoing procedural sedation in the emergency department: a systematic review and meta-analysis. Acad Emerg Med 2016; 23: 119-34. PMID: 26801209

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