Profiling adverse respiratory events and vomiting when using propofol for emergency department procedural sedation

Bell, Anthony, Treston, Greg, McNabb, Charley, Monypenny, Kathy and Cardwell, Robert (2007) Profiling adverse respiratory events and vomiting when using propofol for emergency department procedural sedation. Emergency Medicine Australasia, 19 5: 405-410. doi:10.1111/j.1742-6723.2007.00982.x


Author Bell, Anthony
Treston, Greg
McNabb, Charley
Monypenny, Kathy
Cardwell, Robert
Title Profiling adverse respiratory events and vomiting when using propofol for emergency department procedural sedation
Journal name Emergency Medicine Australasia   Check publisher's open access policy
ISSN 1742-6731
1742-6723
Publication date 2007-10-01
Year available 2007
Sub-type Article (original research)
DOI 10.1111/j.1742-6723.2007.00982.x
Open Access Status Not yet assessed
Volume 19
Issue 5
Start page 405
End page 410
Total pages 6
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Abstract Objectives: To evaluate the rate of adverse respiratory events and vomiting among ED patients undergoing procedural sedation with propofol.
Formatted abstract
Objectives: To evaluate the rate of adverse respiratory events and vomiting among ED patients undergoing procedural sedation with propofol.
Methods: This was a prospective, observational series of patients undergoing procedural sedation. Titrated i.v. propofol was administered via protocol. Fasting status was recorded.
Results: 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%).
Conclusions: 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.
Keyword Conscious sedation
Emergency medicine
Fasting
Propofol
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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