RT Book, Section
A1 Myers, Justin G.
A1 Kelly, Jennifer
A2 Tintinalli, Judith E.
A2 Ma, O. John
A2 Yealy, Donald M.
A2 Meckler, Garth D.
A2 Stapczynski, J. Stephan
A2 Cline, David M.
A2 Thomas, Stephen H.
SR Print(0)
ID 1166529885
T1 Procedural Sedation and Analgesia in Adults
T2 Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260019933
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1166529885
RD 2022/08/15
AB Procedural  sedation  and  analgesia  (PSA)  for  unscheduled,  time-sensitive  procedures  is  a  standard  practice  in  the  ED.1,2The  accepted  definition  and  goals  of  PSA  are  “the  use  of  anxiolytic,  sedative,  hypnotic,  analgesic,  and/or  dissociative  medications(s)  to  attenuate  anxiety,  pain  and/or  motion.  These  agents  are  administered  in  order  to  facilitate  amnesia  or  decreased  awareness  and/or  patient  comfort  and  safety  during  a  diagnostic  or  therapeutic  procedure.”1-5  Levels  of  sedation  are  defined  by  the  patient’s  level  of  responsiveness  and  cardiopulmonary  function,  not  by  the  agents  used  (Table  37-1).6  Although  these  are  the  currently  accepted  definitions  of  levels  of  sedation,  sedation  is  a  continuum,  and  responsiveness  alone  is  not  a  perfect  tool  to  judge  the  level  of  sedation.4,7,8  By  definition,  patients  receiving  PSA  do  not  require  routine  airway  protection  with  endotracheal  intubation  or  other  airway  adjuncts.  This  is  in  contrast  to  provision  of  general  anesthesia,  which  typically  requires  airway  protection.  This  chapter  focuses  on  PSA  in  adults.  For  children,  see  Chapter  115,  “Pain  Management  and  Procedural  Sedation  in  Infants  and  Children.”