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Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
| Section 5. Analgesia, Anesthesia, and Procedural Sedation > |
Chapter 41. Procedural Sedation and Analgesia
Sections: Procedural Sedation and Analgesia: Introduction, Sedation Level, Patient Evaluation, Risks and Precautions, Equipment, Procedural Sedation Monitoring, Step-by-Step Technique, Sedation Agents, Outcome Assessment/Complications, Follow-Up and Patient Instructions, Special Circumstances, Acknowledgment, References.
Topics Discussed: sedation during medical procedure.
Excerpt:"Procedural sedation is the administration of sedatives
or dissociative anesthetics to induce a depressed level of consciousness
while maintaining cardiorespiratory function so that a medical procedure
can be performed with little or no patient reaction or memory.1 Procedural
sedation and analgesia (PSA) is the addition of agents to reduce
or eliminate pain.1 Levels of PSA are defined by
the patient's level of responsiveness and cardiopulmonary
function, not by the agents used (Table 41-1).2 By definition,
patients receiving PSA do not require routine airway protection
with endotracheal intubation or other airway adjuncts, as compared with
general anesthesia that typically requires airway protection. Procedural
sedation is commonly done for scheduled outpatient medical procedures
by a variety of non-anesthesiology physicians.3,4 Protocols
and procedures developed for these elective procedures emphasize
patient assessment and preparation to minimize the risk of PSA to
the lowest level possible, and if the patient does not satisfy all
the criteria for proceeding, the procedure can be rescheduled. Procedural
sedation performed in the ED presents different issues to the practitioner
(Table 4..."
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