lets wrap this thread up by referring to the recently published document "Implementing
and ensuring Safe Sedation Practice for healthcare proceedures in adults" now
on the Royal College of Anaesthetists website:
www.rcoa.ac.uk
and start a different tack - what people think the "methods appropriate to clinical
practice in (A&E)"
are and how they may differ from the Report's framework guidelines.
I would offer that verbal contact is not always maintained in A&E sedation because
pain levels often necessitate large doses of analgesics; therefore conscious
sedation is not always the target. Is this safe practice? And what about ketamine
"sedation"? The clinical picture is different, the physiological responses different
to the usual anxiolytic/hypnotic states. Do emergency physicians in this country
have appropriate training - is the 3 month Anaesthetic secondment enough?(see
RSI discussions)
sorry Im going on a bit - its a topic of interest to me!
Marten C. Howes MRCP(UK)
Specialist Registrar
Accident and Emergency Medicine
Royal Preston Hospital
Lancashire
PR2 9HT
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