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Friday, May 13, 2016

Procedural sedation errors in the ED

emDocs - May 11, 2016 - Authors: Vetter N and Sturm J
Edited by: Robertson J and Koyfman A 
  • Error #1: Delaying deep sedation until fasting times are met
  • Error #2: Believing PSA carries less risk than endotracheal intubation
  • Error #3: Minimizing risk of airway and breathing complications while using ketamine
  • Error #4: Not having full intubation setup nearby
  • Error #5: Responding to hypoventilation or apnea with early and/or aggressive use of the bag-valve mask (BVM)
  • Error #6: If the oxygen saturation is ok, then the patient is breathing ok
  • Error #7: Withholding ketamine sedation on adults
  • Error #8: Adding an opioid with ketamine for sedation
  • Error #9: Using the same dosing strategy for propofol sedations as with fentanyl/midazolam
  • Error #10: Using the same PSA dosing strategy for the elderly