Procedural Sedation and Analgesia in the Emergency Department

Show Notes

• Procedural sedation and analgesia (PSA): terminology
• Levels of sedation
  • Minimal
  • Moderate
  • Deep
  • General anesthesia
• Prehospital care
• ED care: patient assessment
  • ASA class system
  • Complications
  • Equipment needed (Table 1)
  • Larson maneuver (Figure 2)
• Procedural technique
  • Current ACEP and AAP recommendations
  • Data for 1- or 2-physician sedation
• Preprocedural fasting
  • Do we even need to consider this in PSA?
• Capnography
• Oxygen supplementation
• Preprocedural opioids
• Preprocedural sedatives
• Anticholinergics
• Antiemetics
• Treatment (Table 2)
  • Fentanyl
  • Remifentanil
  • Midazolam
  • Nitrous oxide
  • Propofol
  • Ketamine
  • Ketofol
  • Etomidate
• Reversal agents
  • Naloxone
  • Flumazenil
• Special populations
  • Pediatrics
  • Pregnancy
  • Geriatrics
• 16.Cutting edge
  • Dexmedetomidine