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Procedural sedation emergency department

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https://www.readbyqxmd.com/read/28802082/ketamine-or-ketofol-do-we-have-enough-evidence-to-know-which-one-to-use
#1
James Miner
Ketamine and propofol are both commonly used emergency department (ED) procedural sedation agents. Their concurrent administration, often referred to as "ketofol", is widely used for procedural sedation. A simple google search can lead to a lot of opinions on why we should use propofol, ketamine, or ketofol in a given situation for moderate or deep procedural sedation in the ED, but finding evidence that supports differences these opinions assume is much harder to come by. This article is protected by copyright...
August 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28782658/patterns-of-treatment-of-accidental-genital-trauma-in-girls
#2
Tazim Dowlut-McElroy, Jeanette Higgins, Karen B Williams, Julie L Strickland
STUDY OBJECTIVE: To evaluate the characteristics of girls with accidental genital trauma (AGT) who can be managed in the emergency department (ED) versus the operating suite (OS). DESIGN: Retrospective cohort. SETTING: ED at a children's hospital in a metropolitan area. PARTICIPANTS: Girls aged 0 to 18 years with AGT. MAIN OUTCOME MEASURES: Factors associated with need for evaluation and repair of AGT in the OS...
August 3, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28754357/what-is-the-utility-of-end-tidal-capnography-for-procedural-sedation-and-analgesia-in-the-emergency-department
#3
EDITORIAL
Michael Gottlieb, Melissa Rice
No abstract text is available yet for this article.
July 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28750729/-preparation-of-sedation-analgesia-procedures-in-spanish-paediatric-emergency-departments-a-descriptive-study
#4
Concepción Míguez, Niki Oikonomopoulou, Jorge Lorente, Paula Vázquez
INTRODUCTION: The objective of this study was to describe the current practice regarding the preparation of the sedation-analgesia (SA) procedures performed in the paediatric emergency centres in Spain. MATERIAL AND METHODS: A multicentre, observational and prospective analytical study was carried out on the SA procedures that were performed on children under 18 years-old in 18 paediatric emergency departments between February 2015 and January 2016. RESULTS: A total of 658 SA procedures were registered in 18 hospitals of Spain, most of them to children older than 24 months...
July 24, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28729305/biomechanical-reposition-techniques-in-anterior-shoulder-dislocation-a-randomised-multicentre-clinical-trial-the-brasd-trial-protocol
#5
David N Baden, Martijn H Roetman, Tom Boeije, Floris Roodheuvel, Nieke Mullaart-Jansen, Suzanne Peeters, Mike D Burg
INTRODUCTION: Glenohumeral (shoulder) dislocations are the most common large joint dislocations seen in the emergency department (ED). They cause pain, often severe, and require timely interventions to minimise discomfort and tissue damage. Commonly used reposition or relocation techniques often involve traction and/or leverage. These techniques have high success rates but may be painful and time consuming. They may also cause complications. Recently, other techniques-the biomechanical reposition techniques (BRTs)-have become more popular since they may cause less pain, require less time and cause fewer complications...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28680511/emergency-department-procedural-sedation-for-primary-electrical-cardioversion-a-comparison-with-procedural-sedations-for-other-reasons
#6
Michael Butler, Patrick Froese, Peter Zed, George Kovacs, Robert MacKinley, Kirk Magee, Mary-Lynn Watson, Samuel G Campbell
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia treated in the emergency department (ED), with primary electrical cardioversion (PEC) the preferred method of rhythm control. Anecdotally, patients undergoing ED procedural sedation (EDPS) for PEC differ from those requiring EDPS for other procedures: they are at higher risk of adverse events, and require fewer drugs and lower doses. We attempt to verify this using an EDPS registry at a Canadian, tertiary care teaching hospital...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#7
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28625000/mechanical-restraint-in-an-emergency-department-a-consecutive-series-of-593-cases
#8
Nicolas Beysard, Bertrand Yersin, Pierre-Nicolas Carron
The objective is to describe the characteristics of mechanically restrained patients in the emergency department (ED) of a university hospital and to evaluate the quality of restraint documentation that was filled out according to the dedicated protocol with respect to the law on restraint. All adult patients (≥16 years) who were admitted to the ED from January 2009 to December 2010 and were mechanically restrained were included. We assessed medical and demographic characteristics, the completeness of the dedicated protocol, and the concomitant use of chemical sedation...
June 17, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28621182/-non-intubated-uniportal-video-assisted-thoracic-surgery-vats-lobectomy-as-a-new-procedure-in-our-department
#9
József Furák, Zsolt Szabó, Theodor Horváth, Tibor Géczi, Balázs Pécsy, Tibor Németh, Aurél Ottlakán, Zsolt Molnár, György Lázár
AIM: Due to the emerging experience in VATS (video assisted thoracic surgery) lobectomies, in some centers the so called "non-intubated" VATS lobectomies (NITS - non-intubated thoracic surgery) gained increased authority, during which endotracheal intubation and muscle relaxation of the patient is not carried out, thus surgery is being performed with the patient breathing spontaneously. The recent study deals with our initial experience gained during uniportal NITS VATS lobectomies. PATIENTS AND METHOD: Between 24...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28587704/between-and-within-site-variation-in-medication-choices-and-adverse-events-during-procedural-sedation-for-electrical-cardioversion-of-atrial-fibrillation-and-flutter
#10
David Clinkard, Ian Stiell, Eddy Lang, Stuart Rose, Catherine Clement, Robert Brison, Brian H Rowe, Bjug Borgundvaag, Trevor Langhan, Kirk Magee, Rob Stenstrom, Jeffery J Perry, David Birnie, George Wells, Andrew McRae
OBJECTIVES: Although procedural sedation for cardioversion is a common event in emergency departments (EDs), there is limited evidence surrounding medication choices. We sought to evaluate geographic and temporal variation in sedative choice at multiple Canadian sites, and to estimate the risk of adverse events due to sedative choice. METHODS: This is a secondary analysis of one health records review, the Recent Onset Atrial Fibrillation or Flutter-0 (RAFF-0 [n=420, 2008]) and one prospective cohort study, the Recent Onset Atrial Fibrillation or Flutter-1 (RAFF-1 [n=565, 2010 - 2012]) at eight and six Canadian EDs, respectively...
June 7, 2017: CJEM
https://www.readbyqxmd.com/read/28562388/procedural-sedation-in-the-icu-and-emergency-department
#11
Nikhil Chawla, Adjoa Boateng, Ranjit Deshpande
PURPOSE OF REVIEW: Procedures are increasingly being performed in the acute care setting, outside of the operating rooms (OR). This article aims to review the current literature on out-of-OR procedural sedation with a focus on the ICU and emergency department, highlighting the following topics: multidisciplinary team approach, choice of pharmacologic agent, sedation scales, current safety guidelines, anticipating complications, appropriate monitoring and necessary resources. RECENT FINDINGS: Subjective assessment of sedation using sedation scales is controversial...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28552271/comparing-the-success-rates-of-standard-and-modified-valsalva-maneuvers-to-terminate-psvt-a-randomized-controlled-trial
#12
Şeref Kerem Çorbacıoğlu, Emine Akıncı, Yunsur Çevik, Halit Aytar, Mehmet Veysel Öncül, Sedat Akkan, Hüseyin Uzunosmanoğlu
PURPOSE: The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the standard VM in terminating paroxysmal supraventricular tachycardia (PSVT). METHODOLOGY: This randomized controlled trial was conducted in the emergency department of a training and research hospital between Dec. 1, 2015 and Dec. 31, 2016. Participants were divided into two groups, randomly assigned standard VM or modified VM, as the first treatment with two-dimensional permutation blocks; in the order of arrival of the patients...
May 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28466184/thirty-day-emergency-room-visits-and-hospital-admissions-after-outpatient-non-vascular-image-guided-procedures
#13
Quang Nguyen, Sahil V Mehta, Jieming Fang, Robert Sheiman, Robert Kane, Muneeb Ahmed, Ammar Sarwar, Bettina Siewert, Olga R Brook
PURPOSE: To evaluate the rate of post-procedure emergency department (ED) visits and hospital admissions following outpatient non-vascular image-guided interventions performed under moderate sedation and to identify common and preventable causes of emergency department visits and hospital admissions. MATERIALS AND METHODS: Institutional review board approval was acquired for this HIPAA-compliant retrospective study with waiver of informed consent. 1426 consecutive patients undergoing 1512 outpatient image-guided procedures under moderate sedation from November 2012 to August 2014 were included...
May 2, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28460809/ultrasound-guided-interscalene-nerve-block-vs-procedural-sedation-by-propofol-and-fentanyl-for-anterior-shoulder-dislocations
#14
Esmaeil Raeyat Doost, Mohammad Mehdi Heiran, Mitra Movahedi, Amirhossein Mirafzal
BACKGROUND: Few studies were performed to compare ultrasound guided brachial plexus block with procedural sedation for reduction of shoulder dislocations in the Emergency Department (ED). This study was done to provide further evidence regarding this comparison. METHODS: This was a randomized clinical trial performed on patients presenting with anterior shoulder dislocations to the emergency department of an academic level 2 trauma center. Exclusion criteria were any contraindications to the drugs used, any patient which may not be potentially assigned into both groups because of an underlying medical condition, presence of neurovascular compromise related to the dislocation, presence of concomitant fractures, and patient refusal to participate in the study...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28457743/the-information-needs-of-patients-receiving-procedural-sedation-in-a-hospital-emergency-department
#15
Sue Revell, Judy Searle, Shona Thompson
This research investigated the information needs of patients receiving ED procedural sedation to determine the best format to consistently deliver key information in a way acceptable to all involved. Of particular interest was the question concerning patients' need for receiving written information. A descriptive exploratory study gathered qualitative data through face-to-face interviews and focus groups involving patients, nurses and medical staff. Individual interviews were conducted with eight adult patients following procedural sedation...
July 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28438447/randomized-clinical-trial-of-propofol-versus-alfentanil-for-moderate-procedural-sedation-in-the-emergency-department
#16
James R Miner, Brian E Driver, Johanna C Moore, Erik Faegerstrom, Lauren Klein, Matthew Prekker, Jon B Cole
STUDY OBJECTIVE: To compare the frequency of airway and respiratory adverse events leading to an intervention between moderate sedation using alfentanil or propofol. METHODS: We performed a randomized clinical trial in which adults undergoing moderate sedation in the ED received either alfentanil or propofol. Our primary outcome was the frequency of airway and respiratory adverse events leading to an intervention. Other outcomes included sedation depth, efficacy, sedation time, patient satisfaction, pain, and satisfaction...
April 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433211/adverse-events-during-a-randomized-trial-of-ketamine-versus-co-administration-of-ketamine-and-propofol-for-procedural-sedation-in-a-pediatric-emergency-department
#17
Keith Weisz, Lalit Bajaj, Sara J Deakyne, Lina Brou, Alison Brent, Joseph Wathen, Genie E Roosevelt
BACKGROUND: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. OBJECTIVE: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). METHODS: This was a prospective, randomized, single-blinded, controlled trial of KM vs...
April 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28416265/comparison-of-outcomes-for-pediatric-paraphimosis-reduction-using-topical-anesthetic-versus-intravenous-procedural-sedation
#18
Brett Burstein, Raphael Paquin
BACKGROUND: Paraphimosis is an acute urologic emergency requiring urgent manual reduction, frequently necessitating procedural sedation (PS) in the pediatric population. The present study sought to compare outcomes among pediatric patients undergoing paraphimosis reduction using a novel topical anesthetic (TA) technique versus PS. METHODS: We performed a retrospective analysis of all patients <18years old, presenting to a tertiary pediatric ED requiring analgesia for paraphimosis reduction between October 2013 and September 2016...
April 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28395927/correction-correction-to-clinical-policy-procedural-sedation-and-analgesia-in-the-emergency%C3%A2-department-annals-of-emergency-medicine-63-2014-247-258-e18
#19
Steven A Godwin, John H Burton, Charles J Gerardo, Benjamin W Hatten, Sharon E Mace, Scott M Silvers, Francis M Fesmire
Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in PubMed. This has now been corrected online. The publisher would like to apologize for any inconvenience caused.
April 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28371459/patient-satisfaction-with-procedural-sedation-in-the-emergency-department
#20
Olivia G Johnson, David McD Taylor, Marina Lee, Juen-Li Ding, Aadith Ashok, Damian Johnson, Daniel Peck, Jonathan Knott, Laurence Weinberg
OBJECTIVE: The aim of this study was to determine patient satisfaction with procedural sedation as a function of nature of the procedure and depth of sedation. METHOD: We undertook a prospective observational study of adult patients who received procedural sedation in two EDs (20 month period). The level of sedation was determined by an investigator, using the Observers Assessment of Anaesthesia/Sedation Scale (1 = awake to 6 = no response to noxious stimuli)...
June 2017: Emergency Medicine Australasia: EMA
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