Procedural sedation in a tertiary referral trauma centre: A retrospective audit
Procedural sedation complications are common in Australasian Emergency Departments (EDs). This study aimed to compare procedural sedation complications between The Canberra Hospital ED (TCH ED) and the available Australasian literature and to determine if sedation associated complications were amena...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2019-08-01
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| Series: | Emergency Care Journal |
| Subjects: | |
| Online Access: | https://www.pagepressjournals.org/index.php/ecj/article/view/8214 |
| _version_ | 1818216823285350400 |
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| author | James Falconer Drew Richardson |
| author_facet | James Falconer Drew Richardson |
| author_sort | James Falconer |
| collection | DOAJ |
| description | Procedural sedation complications are common in Australasian Emergency Departments (EDs). This study aimed to compare procedural sedation complications between The Canberra Hospital ED (TCH ED) and the available Australasian literature and to determine if sedation associated complications were amenable to simple intervention. All procedural sedations performed over two and half years in TCH ED were retrospectively reviewed. Complications were defined as per the previous comparable Australasian study, as those events requiring an intervention. 1793 sedations were reviewed: 1125 (63%) for orthopaedic procedures, other 276 (a collection of painful procedures), 208 suturing and 169 direct current cardioversions. The median age was 29 years with 538 (30%) children under the age of 16 years. The complication rate in the initial six-months was 4.0% dropping to 1.3% after multiple education sessions before rebounding to 3.1% in the last six-months. The overall complication rate was 3.1% (95% CI 2.3-4.0) which is significantly lower (P<0.0001) than the comparable previous major Australian study (7.2%, 95% CI 6.2-8.2). There was significantly less use of Midazolam (10.3% vs 23.8% P<0.00001) and Morphine (1.5% vs 7.9% P<0.00001). There was one case of laryngospasm requiring intubation but subsequently discharged at baseline, otherwise no recorded major adverse events. Therefore procedural sedation at TCH ED has a complication rate less than that previously reported and this may be due to evolution of the agents used. The complications seem to be readily amenable to education around prevention, but the benefit of these education sessions appears to decay over time. |
| first_indexed | 2024-12-12T06:58:06Z |
| format | Article |
| id | doaj.art-4d5581c75cb644eb8ae0781dcadc8b86 |
| institution | Directory Open Access Journal |
| issn | 1826-9826 2282-2054 |
| language | English |
| last_indexed | 2024-12-12T06:58:06Z |
| publishDate | 2019-08-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Emergency Care Journal |
| spelling | doaj.art-4d5581c75cb644eb8ae0781dcadc8b862022-12-22T00:33:54ZengPAGEPress PublicationsEmergency Care Journal1826-98262282-20542019-08-0115210.4081/ecj.2019.8214Procedural sedation in a tertiary referral trauma centre: A retrospective auditJames Falconer0Drew Richardson1Emergency Department, Canberra Hospital and Health Service, Garran, Australian Capital Territories; Australian National University, Australian Capital TerritoriesEmergency Department, Canberra Hospital and Health Service, Garran, Australian Capital Territories; Australian National University, Australian Capital TerritoriesProcedural sedation complications are common in Australasian Emergency Departments (EDs). This study aimed to compare procedural sedation complications between The Canberra Hospital ED (TCH ED) and the available Australasian literature and to determine if sedation associated complications were amenable to simple intervention. All procedural sedations performed over two and half years in TCH ED were retrospectively reviewed. Complications were defined as per the previous comparable Australasian study, as those events requiring an intervention. 1793 sedations were reviewed: 1125 (63%) for orthopaedic procedures, other 276 (a collection of painful procedures), 208 suturing and 169 direct current cardioversions. The median age was 29 years with 538 (30%) children under the age of 16 years. The complication rate in the initial six-months was 4.0% dropping to 1.3% after multiple education sessions before rebounding to 3.1% in the last six-months. The overall complication rate was 3.1% (95% CI 2.3-4.0) which is significantly lower (P<0.0001) than the comparable previous major Australian study (7.2%, 95% CI 6.2-8.2). There was significantly less use of Midazolam (10.3% vs 23.8% P<0.00001) and Morphine (1.5% vs 7.9% P<0.00001). There was one case of laryngospasm requiring intubation but subsequently discharged at baseline, otherwise no recorded major adverse events. Therefore procedural sedation at TCH ED has a complication rate less than that previously reported and this may be due to evolution of the agents used. The complications seem to be readily amenable to education around prevention, but the benefit of these education sessions appears to decay over time.https://www.pagepressjournals.org/index.php/ecj/article/view/8214SedationProcedural sedationComplicationsEmergency DepartmentEmergency procedures |
| spellingShingle | James Falconer Drew Richardson Procedural sedation in a tertiary referral trauma centre: A retrospective audit Emergency Care Journal Sedation Procedural sedation Complications Emergency Department Emergency procedures |
| title | Procedural sedation in a tertiary referral trauma centre: A retrospective audit |
| title_full | Procedural sedation in a tertiary referral trauma centre: A retrospective audit |
| title_fullStr | Procedural sedation in a tertiary referral trauma centre: A retrospective audit |
| title_full_unstemmed | Procedural sedation in a tertiary referral trauma centre: A retrospective audit |
| title_short | Procedural sedation in a tertiary referral trauma centre: A retrospective audit |
| title_sort | procedural sedation in a tertiary referral trauma centre a retrospective audit |
| topic | Sedation Procedural sedation Complications Emergency Department Emergency procedures |
| url | https://www.pagepressjournals.org/index.php/ecj/article/view/8214 |
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