ED Sedation with Propofol, Endotracheal Assist Maneuvers, and Ondansetron for Pediatric Gastroenteritis
Abstract
Learning Objectives: After reading this article, the physician should be able to: Explain the indications, contraindications, recommended dosage, risks, and side effects of propofol for procedural sedation in the ED. Describe the potential for bimanual laryngoscopy to be superior to other assist maneuvers during endotracheal intubation. Summarize the data using ondansetron for pediatric gastroenteritis. Release Date: January 2009 From the 2009 LLSA Reading List Clinical Practice Advisory: Emergency Department Procedural Sedation with Propofol Miner JR, Burton, JH Ann Emerg Med 2007;50(2):182 Propofol has emerged as one of the most popular agents for procedural sedation in the ED due to its rapid onset, short duration, rapid recovery period, and proven track record. It is still a relatively new agent in the procedural sedation arsenal, however. The ability of propofol to induce rapid deterioration in consciousness, hypotension, apnea, and even general anesthesia makes it prudent to provide evidence-based recommendations on its use. Propofol has a relatively good body of evidence supporting its use. A recent clinical policy statement on Procedural Sedation and Analgesia from the American College of Emergency Physicians graded safety evidence higher for propofol (Level B) than etomidate (Level C). (Ann Emerg Med 2005;45[2]:177.) Propofol is a non-dissociative sedative indicated for deep sedation on patients requiring sedation for short emergent procedures. Other agents are…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 1,698 participants or records.
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