7
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      Procedural sedation with propofol for emergency DC cardioversion

      ,
      Emergency Medicine Journal
      BMJ

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Many emergency patients present with cardiac arrhythmias requiring emergency direct current countershock cardioversion (DCCV) as a part of their management. Almost all require sedation to facilitate the procedure. Propofol has been used for procedural sedation in Emergency Medicine since 1995. In 1996, in a review article in Anaesthesia, it was recommended as the drug which most closely approaches the ideal agent for DCCV. However, the existing evidence for the dosage requirements and safety of propofol in emergency DCCV is limited. We report a prospective case series of patients who underwent sedation-facilitated DCCV using propofol in the emergency department with both sedation and DCCV delivered by emergency physicians. The results indicate propofol is a safe drug for procedural sedation to facilitate emergency DCCV in patients with an atrial tachyarrhythmia without any evidence of haemodynamic compromise. A dose of 1 mg/kg appears to be safe in the majority of these patients. Using the adverse event reporting tool produced by the World SIVA International Sedation Task Force there were no moderate or sentinel adverse events in these patients. A reduced dose should be considered in older patients to prevent transient complications. Propofol at a dose of 0.5 mg/kg appears to be a safe drug for procedural sedation to facilitate emergent or urgent DCCV in patients with an atrial tachyarrhythmia with evidence of haemodynamic compromise. There were no sentinel adverse events associated with its use. Evidence to support the use of propofol to facilitate emergency DCCV for ventricular tachycardia is limited.

          Related collections

          Most cited references18

          • Record: found
          • Abstract: found
          • Article: not found

          Adverse event reporting tool to standardize the reporting and tracking of adverse events during procedural sedation: a consensus document from the World SIVA International Sedation Task Force.

          Currently, there are no established definitions or terminology for sedation-related adverse events (AEs). With clear terminology and definitions, sedation events may be accurately identified and tracked, providing a benchmark for defining the occurrence of AEs, ranging from minimal to severe. This terminology could apply to sedation performed in any location and by any provider. We present a consensus document from the International Sedation Task Force (ISTF) of the World Society of Intravenous Anaesthesia (World SIVA). The ISTF is composed of adult and paediatric sedation practitioners from multiple disciplines throughout the world.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Consensus-based recommendations for standardizing terminology and reporting adverse events for emergency department procedural sedation and analgesia in children.

            Children commonly require sedation and analgesia for procedures in the emergency department. Establishing accurate adverse event and complications rates from the available literature has been difficult because of the difficulty in aggregating results from previous studies that have used varied terminology to describe the same adverse events and outcomes. Further, serious adverse events occur infrequently, necessitating the study of large numbers of children to assess safety. These limitations prevent the establishment of a sufficiently large database on which evidence-based practice guidelines may be based. We assembled a panel of pediatric sedation researchers and experts to develop consensus-based recommendations for standardizing procedural sedation and analgesia terminology and reporting of adverse events. Our goal was to create a uniform reporting mechanism for future studies to facilitate the aggregation and comparison of results.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Clinical practice advisory: Emergency department procedural sedation with propofol.

              We present an evidence-based clinical practice advisory for the administration of propofol for emergency department procedural sedation. We critically discuss indications, contraindications, personnel and monitoring requirements, dosing, coadministered medications, and patient recovery from propofol. Future research questions are considered.
                Bookmark

                Author and article information

                Journal
                Emergency Medicine Journal
                Emerg Med J
                BMJ
                1472-0205
                1472-0213
                October 17 2014
                November 2014
                November 2014
                July 29 2013
                : 31
                : 11
                : 904-908
                Article
                10.1136/emermed-2013-202742
                23896591
                1f957ec1-016d-42bb-9cf3-2da531a39854
                © 2013
                History

                Comments

                Comment on this article