Sedation and anesthesia for diagnostic and therapeutic procedures in acute trauma patients outside the operating room.

Abstract

Sedation and anesthesia techniques are commonly used for a variety of diagnostic and therapeutic procedures outside of the operating room, and these techniques are becoming more commonly used in acutely injured trauma patients. This is due to increasing demands for precious operating room resources, as well as the more widespread availability of better and more cost-effective monitoring. Nonetheless, this trend poses additional safety concerns compared with the practice of providing sedation for elective diagnostic and therapeutic procedures. Several recent guidelines have been published for the use of conscious sedation techniques in the elective setting (Joint Commission on the Accreditation of Health Care Organizations, American Academy of Pediatrics, American Society of Anesthesiologists, and the Australian and New Zealand College of Anaesthetists). 1 - 4 These guidelines target patient safety and address issues such as preoperative medical assessment, monitoring, personnel training and expert availability, emergency resuscitation personnel, and equipment. However, none of these guidelines specifically addresses sedation issues in the acute trauma situation.