External direct current (DC) cardioversion is a commonly used method of terminating atrial arrhythmias. The chance of procedural success is inversely related to the duration of the arrhythmia. In many hospitals, the procedure is carried out under general anaesthesia, necessitating the presence of anaesthetic as well as medical staff. Frequently, it may be difficult to coordinate the availabilit...

Background: The aim of the study was to determine the efficacy and adverse effects of intravenous (iv) ketamine sedation administered by non-anesthetist physicians for painful procedures. Methods: A single-agent, procedural sedation protocol using titrated doses of ketamine iv (maximum 2 mg·kg 1 ) was conducted in outpatient pediatric oncology patients undergoing lumbar puncture (LP), bone marr...

INTRODUCTION Violent and agitated patients pose a serious challenge for emergency medical services (EMS) personnel. Rapid control of these patients is paramount to successful prehospital evaluation and also for the safety of both the patient and crew. Sedation is often required for these patients, but the ideal choice of medication is not clear. The objective is to demonstrate that ketamine, gi...

A very common clinical scenario: a middle-aged patient suddenly collapses at home/at work/in the community, pulseless. The emergency medical service is called, the patient resuscitated, and rushed to the emergency department. The emergency room physician asks for the admission of a comatose patient after out-ofhospital cardiac arrest (OHCA). The likelihood of survival at this point is determine...

Despite recent advances in our understanding of paediatric pain and its management, pain continues to be undertreated globally, particularly in children and in low income countries. This article describes the development of a paediatric analgesia and sedation protocol, tailored to the specific setting of the Medical Research Council (MRC) paediatric ward in the Gambia, West Africa. An iterative...

INTRODUCTION Midazolam and propofol used alone for long-term sedation are associated with adverse effects. Sequential use may reduce the adverse effects, and lead to faster recovery, earlier extubation and lower costs. This study evaluates the effects, safety, and cost of midazolam, propofol, and their sequential use for long-term sedation in critically ill mechanically ventilated patients. M...

BACKGROUND Sedation prior to performance of diagnostic esophagogastroduodenoscopy (EGDE) is widespread and increases patient comfort. But 98% of all serious adverse events during EGDEs are ascribed to sedation. The S3 guideline for sedation procedures in gastrointestinal endoscopy published in 2008 in Germany increases patient safety by standardization. These new regulations increase costs beca...

Preliminary results indicate that ketamine 3mg/kg combined with diazepam and atropine may be an excellent premedication/sedation for children who require dental treatment procedures 45-60 minutes in duration. Ketamine HCI, 4 mg/kg appears to be effective for procedures lasting less than 30 minutes. Because of transient apnea, noted in two references, 2"3 only dentists trained in airway manageme...

If a similar goal-directed approach had been applied in the Basel study [1] , the administration of lower doses of propofol would (likely) have been associated with less cardiopulmonary compromise, particularly among the high-risk patients. Over recent years, propofol has emerged as a 'near ideal' sedative drug with dose-dependent hypnotic effects, rapid onset and a fast recovery profile [7]. S...