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Procedural Sedation and AnalgesiaAka: Procedural Sedation, Conscious Sedation, Sedation, PSAA

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  1. See Also
    1. Labor Sedation
    2. Local Skin Anesthesia
  2. Definitions
    1. PSAA has replaced term conscious sedation
  3. Indications
    1. Adult precedural sedation
      1. Fracture or dislocation reduction
      2. Significant Wound Debridement
      3. Rectal foreign body
      4. Ketamine is usually preferred in children
    2. Child procedural sedation
      1. Ear Foreign Body
      2. Entrapment of penis in zipper
      3. Abscess Incision and Drainage
      4. Imaging studies
      5. Laceration Repair or Wound Debridement
      6. Fracture or dislocation reduction
  4. Contraindications
    1. Significant or unstable cormorbid illness
  5. Preparation
    1. Requires provider experienced in sedation
      1. Knowledgeable about sedatives and monitoring
      2. Skilled in ABC Management
    2. Fasting is preferred prior to procedure
      1. Food intake is not absolute contraindication
        1. Aspiration is less likely with fasting
        2. Urgent procedures may be performed without fast
      2. Guidelines
        1. No food in last 6 hours
        2. No clear liquids in last 2 hours
    3. Monitoring during procedure
      1. Cardiac monitoring
      2. Pulse oximetry
    4. Emergency equipment
      1. Oxygen Delivery
      2. Airway Suction equipment
      3. Bag-valve mask
      4. Intubation equipment
      5. Resuscitation cart
      6. Reversal agents
        1. Naloxone
        2. Flumazenil
  6. Agents
    1. Adults
      1. Etomidate (preferred agent)
      2. Fentanyl with Midazolam
    2. Children
      1. Ketamine (preferred agent)
      2. Fentanyl with Midazolam
      3. Chloral Hydrate
        1. Replaced by Ketamine
  7. References
    1. Brown (2005) Am Fam Physician 71:85

Conscious Sedation (C0079159)

Definition (MSH)A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)
ConceptsTherapeutic or Preventive Procedure (T061)
MSHD016292
EnglishConscious Sedation, Induction of conscious sedation, Moderate sedation
Spanishsedacion consciente
Parent ConceptsAnesthesia and Analgesia (C0002905), Sedation procedure (C0344106)
SourcesMSH, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Sedation procedure (C0344106)

Definition (NCI)The process of allaying nervous excitement or the state of being calmed. (Taber's)
ConceptsTherapeutic or Preventive Procedure (T061)
EnglishAdministration of sedative, Sedation, Sedation procedure, Sedative therapy
Spanishadministracion de sedante, procedimiento de sedacion, sedacion
Parent Conceptsgeneral therapeutic measure (C0679625), Anesthesia procedures (C0002903), Administration of therapeutic medication (C1608878), Duplicate concept (C1274013)
SourcesAOD, CSP, MTH, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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