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Procedural sedation emergency department

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https://www.readbyqxmd.com/read/29759099/procedural-sedation-by-advanced-care-paramedics-for-emergency-gastrointestinal-endoscopy
#1
Hana M Wiemer, Michael B Butler, Patrick C Froese, Allan Lapierre, Chris Carriere, Glen R Etsell, Dana Farina, Jennifer Jones, Jock Murray, Samuel G Campbell
CLINICIAN'S CAPSULE What is known about the topic? Advanced care paramedics (ACPs) in our emergency department (ED) successfully perform procedural sedation and analgesia (PSA) for several procedures, including orthopedic manipulations. What did this study ask? How does the novel practice of ACP-led ED PSA for upper gastrointestinal (UGI) endoscopy compare to that for orthopedic procedures? What did this study find? Adverse events occurred more frequently during UGI endoscopy sedations than orthopedic sedations (41...
May 15, 2018: CJEM
https://www.readbyqxmd.com/read/29730093/adverse-events-and-satisfaction-with-use-of-intranasal-midazolam-for-emergency-department-procedures-in-children
#2
Laurie Malia, V Matt Laurich, Jesse J Sturm
PURPOSE: Procedural sedation is commonly performed in the emergency department (ED). Having safe and fast means of providing sedation and anxiolysis to children is important for the child's tolerance of the procedure, parent satisfaction and efficient patient flow in the ED. OBJECTIVE: To evaluate fasting times associated with the administration of intranasal midazolam (INM) and associated complications. Secondary objectives included assessing provider and caregiver satisfaction scores...
April 30, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29715217/current-approach-to-the-diagnosis-and-management-of-shoulder-dislocation-in-children
#3
Michael Gottlieb
Shoulder dislocations are a common presentation to the emergency department. Although many cases may be diagnosed by history and clinical examination alone, imaging may help diagnose more challenging cases. Three-view radiographs are important for identifying subtle posterior dislocations, and ultrasonography has been gaining evidence as an alternate diagnostic modality. Intra-articular lidocaine and nerve blocks may improve pain control and reduce the need for procedural sedation. Multiple, evidence-based reduction techniques are described including tips for improving success...
May 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29669351/bronchial-thermoplasty-in-severe-asthma-best-practice-recommendations-from-an-expert-panel
#4
Peter I Bonta, Pascal Chanez, Jouke T Annema, Pallav L Shah, Robert Niven
Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit...
2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29661381/a-review-of-the-safety-and-efficacy-of-inhaled-methoxyflurane-as-an-analgesic-for-outpatient-procedures
#5
REVIEW
C Jephcott, J Grummet, N Nguyen, O Spruyt
Methoxyflurane delivered via a hand-held inhaler is a proven analgesic which has been used in Australasia for emergency relief of trauma associated pain since the 1970s. The agent is self-administered by the patient under the supervision of trained personnel. More than 5 million patients have received inhaled methoxyflurane without significant side effects. Methoxyflurane is also licensed in Australasia for the relief of pain in monitored conscious patients requiring analgesia for minor surgical procedures...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29651740/the-expanding-role-of-ketamine-in-the-emergency-department
#6
Sophia Sheikh, Phyllis Hendry
Patients frequently come to the emergency department for pain. For decades, ketamine has been used in the emergency department for procedural sedation but is now receiving attention as a potential alternative to opioids because of its unique analgesic effects. Additionally, ketamine's dissociative properties have made it a popular choice for sedating profoundly agitated patients. In this narrative review, these new roles for ketamine in the emergency department are discussed.
April 12, 2018: Drugs
https://www.readbyqxmd.com/read/29650431/-efficacy-safety-and-satisfaction-of-sedation-analgesia-in-spanish-emergency-departments
#7
Concepción Míguez Navarro, Niki Oikonomopoulou, Arístides Rivas García, Andrea Mora Capín, Gloria Guerrero Márquez
OBJECTIVES: To offer analgesia and sedation should be a priority in paediatric emergency departments. The aim of this study was to determine the effectiveness and safety of the sedation-analgesia procedure, as well as the satisfaction of the doctors, patients and parents. METHODS: A multicentre, observational, and prospective analytical study was conducted on the sedation-analgesia procedure performed on children younger than 18 years old in 18 paediatric emergency departments in Spain from February 2015 until January 2016...
April 9, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29580286/hematoma-block-or-procedural-sedation-and-analgesia-which-is-the-most-effective-method-of-anesthesia-in-reduction-of-displaced-distal-radius-fracture
#8
Ping-Tao Tseng, Tsai-Hsueh Leu, Yen-Wen Chen, Yu-Pin Chen
BACKGROUND: Procedure sedation and analgesia (PSA) is often used to alleviate discomfort and to facilitate fracture reduction for patients with distal radius fracture in emergency departments and clinics, but risks of respiratory distress and needs for different levels of monitoring under PSA are still under concern. Hematoma block (HB) is a simple alternative method of providing rapid pain relief during reduction of distal radius fracture. However, there is still in lack of strong evidence to promote HB over PSA in clinical practice...
March 27, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29576825/comparison-of-sedative-effectiveness-of-thiopental-versus-midazolam-in-reduction-of-shoulder-dislocation
#9
Elnaz Vahidi, Rezvan Hemati, Mehdi Momeni, Amirhossein Jahanshir, Morteza Saeedi
BACKGROUND: Various sedative drugs have been proposed to control anxiety and agitation in shoulder dislocation, but none of them has been diagnosed as the best sedative and relaxant agent. The study aimed to compare the sedative effectiveness of thiopental versus midazolam in reduction of shoulder dislocation. METHODS: A randomized double-blind controlled trail was performed in 80 patients with shoulder dislocation recruited from the emergency department. Ten patients were excluded and 70 patients were enrolled in the study...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29564214/use-of-ketamine-sedation-for-the-management-of-displaced-paediatric-forearm-fractures
#10
Anatole Vilhelm Wiik, Poonam Patel, Joanna Bovis, Adele Cowper, Philip Socrates Pastides, Alison Hulme, Stuart Evans, Charles Stewart
AIM: To determine if ketamine sedation is a safe and cost effective way of treating displaced paediatric radial and ulna fractures in the emergency department. METHODS: Following an agreed interdepartmental protocol, fractures of the radius and ulna (moderately to severely displaced) in children between the age of 2 and 16 years old, presenting within a specified 4 mo period, were manipulated in our paediatric emergency department. Verbal and written consent was obtained prior to procedural sedation to ensure parents were informed and satisfied to have ketamine...
March 18, 2018: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29560077/higher-mallampati-scores-are-not-associated-with-more-adverse-events-during-pediatric-procedural-sedation-and-analgesia
#11
Maya S Iyer, Raymond D Pitetti, Melissa Vitale
Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Medical governing bodies have proposed guidelines for PSA performed by NAs, but these recommendations rarely suggest using Mallampati scores in pre-PSA evaluations...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29464215/accuracy-of-point-of-care-ultrasound-using-low-frequency-curvilinear-transducer-in-the-diagnosis-of-shoulder-dislocation-and-confirmation-of-appropriate-reduction
#12
Javad Seyedhosseini, Jaleh Saiidian, Amirpejman Hashemi Taheri, Elnaz Vahidi
Background: Ultrasound (US) is an effective modality in the evaluation of shoulder dislocation and reduction. In most studies, high frequency US probes have been used. Objective: To determine the sensitivity and specificity of low frequency US in the diagnosis of shoulder dislocation and its proper reduction in the emergency department (ED). Methods: In a prospective observational study 84 patients, suspicious of shoulder dislocation, were enrolled in our study...
December 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29456990/ketamine-versus-ketamine-magnesium-sulfate-for-procedural-sedation-and-analgesia-in-the-emergency-department-a-randomized-clinical-trial
#13
Reza Azizkhani, Azadeh Bahadori, Mohammadreza Shariati, Keyhan Golshani, Omid Ahmadi, Babak Masoumi
Background: The present study was designed to evaluate the effectiveness of magnesium sulfate (MgSO4 ) in procedural sedation and analgesia (PSA) when combined with ketamine in patients with fractures in emergency departments and required short and painful emergency procedures. Materials and Methods: In this study, 100 patients with fractures and dislocations who were presented to the emergency departments and required PSA for short and painful emergency procedures were randomly allocated to groups of ketamine plus MgSO4 or ketamine alone...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29429580/the-newest-threat-to-emergency-department-procedural-sedation
#14
EDITORIAL
Steven M Green, Mark G Roback, Baruch S Krauss
No abstract text is available yet for this article.
February 2, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29397258/comparison-of-the-combination-of-propofol-fentanyl-with-combination-of-propofol-ketamine-for-procedural-sedation-and-analgesia-in-patients-with-trauma
#15
Hamed Aminiahidashti, Sajad Shafiee, Seyed Mohammad Hosseininejad, Abulfazl Firouzian, Ayyub Barzegarnejad, Alieh Zamani Kiasari, Behzad Feizzadeh Kerigh, Farzad Bozorgi, Misagh Shafizad, Ahmad Geraeeli
OBJECTIVE: Many procedures performed in emergency department are stressful and painful, and creating proper and timely analgesia and early and effective assessment are the challenges in this department. This study has been conducted in order to compare the efficacy of propofol and fentanyl combination with propofol and ketamine combination for procedural sedation and analgesia (PSA) in trauma patients in the emergency department. METHOD: This is a randomized prospective double-blind clinical trial conducted in the emergency department of Imam Khomeini Hospital, a tertiary academic trauma center in northern Iran...
February 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29395760/shortened-preprocedural-fasting-in-the-pediatric-emergency-department
#16
Corrie E Chumpitazi, Elizabeth A Camp, Divya R Bhamidipati, Almea M Montillo, A Chantal Caviness, Lesby Mayorquin, Faria A Pereira
BACKGROUND: There is no evidence of an association between fasting time and the incidence of adverse events during procedural sedation and analgesia. Pediatric and adult emergency medicine guidelines support avoiding delaying procedures based on fasting time. General pediatric guidelines outside emergent care settings continue to be vague and do not support a set fasting period for urgent and emergent procedures. OBJECTIVE: To describe shortened preprocedural fasting and vomiting event rates during the implementation of a shortened fasting protocol...
January 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29372412/the-effect-of-in-situ-simulation-training-on-the-performance-of-tasks-related-to-patient-safety-during-sedation
#17
Meital Ben-Ari, Gilad Chayen, Ivan P Steiner, Dana Aronson Schinasi, Oren Feldman, Itai Shavit
In many countries, procedural sedation outside of the operating room is performed by pediatricians. We examined if in situ sedation simulation training (SST) of pediatricians improves the performance of tasks related to patient safety during sedation in the Emergency Department (ED). We performed a single-center, quasi-experimental, study evaluating the performance of sedation, before-and-after SST. Sixteen pediatricians were evaluated during sedation as part of their usual practice, using the previously validated Sedation-Performance-Score (SPS)...
April 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29358491/ketamine-procedural-sedation-in-the-emergency-department-of-an-urban-tertiary-hospital-in-dar-es-salaam-tanzania
#18
Zlatan Coralic, Hendry R Sawe, Juma A Mfinanga, Alfredo Cortez, Jennifer Koehl, Hannah Siroker, Teri A Reynolds
STUDY OBJECTIVE: We describe ketamine procedural sedations and associated adverse events in low-acuity and high-acuity patients in a resource-limited ED. METHODS: This was a prospective observational study of ketamine procedural sedations at the Emergency Medical Department at the Muhimbili National Hospital in Dar es Salaam, Tanzania. We observed consecutive procedural sedations and recorded patient demographics, medications, vital signs, pulse oximetry, capnography and a priori defined adverse events (using standard definitions in emergency medicine sedation guidelines)...
April 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#19
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29306262/considerations-for-physicians-using-ketamine-for-sedation-of-children-in-emergency-departments
#20
Woo Sung Kim, Ji Yeon Ku, Hanbyul Choi, Hyo Jeong Choi, Ho Jung Kim, Bora Lee
OBJECTIVE: Ketamine use in emergency departments (EDs) for procedural sedation and analgesia is becoming increasingly common. However, few studies have examined patient factors related to adverse events associated with ketamine. This study investigated factors for consideration when using ketamine to sedate pediatric ED patients. METHODS: The study included pediatric patients receiving ketamine for laceration repair in the ED. Before sedation, information was collected about upper respiratory tract infection symptoms, allergy history, and fasting time...
December 2017: Clinical and Experimental Emergency Medicine
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