Procedural Sedation & Analgesia

In this episode, Sam Ashoo, MD interviews Prayag Mehta, MD and Joshua Kern, MD – two of the authors of the June, 2022 EMP article on Procedural Sedation and Analgesia in the Emergency Department. Listen to the discussion to hear more about the emergency medicine approach to sedation in adults and pediatrics !Procedural Sedation and Analgesia in the Emergency DepartmentEMplify – June 2022Episode Outline:1.Procedural sedation and analgesia (PSA): terminology2.Levels of sedationMinimalModerateDeepGeneral anesthesia3.Prehospital care4.ED care: patient assessmentASA class systemComplicationsEquipment needed (Table 1)Larson maneuver (Figure 2)5.Procedural techniqueCurrent ACEP and AAP recommendationsData for 1- or 2-physician sedation6.Preprocedural fastingDo we even need to consider this in PSA?7.Capnography8.Oxygen supplementation9.Preprocedural opioids10.Preprocedural sedatives11.Anticholinergics12.Antiemetics13.Treatment (Table 2)FentanylRemifentanilMidazolamNitrous oxidePropofolKetamineKetofolEtomidate14.Reversal agentsNaloxoneFlumazenil15.Special populationsPediatricsPregnancyGeriatrics16.Cutting edgeDexmedetomidine