Title |
Profiling adverse respiratory events and vomiting when using propofol for emergency department procedural sedation
|
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Published in |
Emergency Medicine Australasia, August 2007
|
DOI | 10.1111/j.1742-6723.2007.00982.x |
Pubmed ID | |
Authors |
Anthony Bell, Greg Treston, Charley McNabb, Kathy Monypenny, Robert Cardwell |
Abstract |
To evaluate the rate of adverse respiratory events and vomiting among ED patients undergoing procedural sedation with propofol. This was a prospective, observational series of patients undergoing procedural sedation. Titrated i.v. propofol was administered via protocol. Fasting status was recorded. Four hundred patients undergoing sedation were enrolled. Of these 282 (70%, 95% confidence interval [CI] 66-75%) had eaten or drunken within 6 and 2 h, respectively. Median fasting times from a full meal, snack or drink were 7 h (interquartile range [IQR] 5-9 h), 6 h (IQR 4-8 h) and 4 h (IQR 2-6 h), respectively. Overall a respiratory event occurred in 86 patients (22%, 95% CI 18-26%). An airway intervention occurred in 123 patients (31%, 95% CI 26-35%). In 111 cases (90%, 95% CI 60-98%) basic airway manoeuvres were all that was required. No patients were intubated. Two patients vomited (0.5%, 95% CI 0.0-1.6%), one during sedation, one after patient became conversational. One patient developed transient laryngospasm (0.25%, 95% CI 0-1.2%) unrelated to vomiting. There were nil aspiration events (0%, 95% CI 0-0.74%). Seventy per cent of patients undergoing ED procedural sedation are not fasted. No patient had a clinically evident adverse outcome. Transient respiratory events occur but can be managed with basic airway interventions making propofol a safe alternative for emergency physicians to provide emergent procedural sedation. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 43 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 6 | 14% |
Student > Bachelor | 6 | 14% |
Student > Postgraduate | 5 | 12% |
Student > Ph. D. Student | 4 | 9% |
Researcher | 3 | 7% |
Other | 8 | 19% |
Unknown | 11 | 26% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 19 | 44% |
Nursing and Health Professions | 6 | 14% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 5% |
Unspecified | 2 | 5% |
Economics, Econometrics and Finance | 1 | 2% |
Other | 3 | 7% |
Unknown | 10 | 23% |