In this article published in the December 2018 issue of the British Columbia Medical Journal, Drs Richard Merchant and Matt Kurrek encourage the use of capnographic monitoring to improve the safety of patients undergoing procedural sedation.
By Richard Merchant, MD, FRCPC (Clinical Professor, University of British Columbia, Department of Anesthesia, Pharmacology, & Therapeutics) explained in a clinical education podcast with Matt Kurrek, MD, FRCPC (Professor, Department of Anesthesia, University of Toronto)
The Physician-Patient Alliance for Health & Safety is pleased to release the Position Statement on Procedural Sedation.
The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Depending on the patient and the medical procedure, many of these are performed under sedation to manage the patient’s pain and/or anxiety without inducing general anesthesia.
The Physician-Patient Alliance for Health & Safety (PPAHS) announced its intention to develop a position statement on recommendations for procedural sedation.
Michael Wong, JD (Founder and Executive Director, PPAHS) explained that such a position statement on recommendations for procedural sedation would encapsulate guidelines and recommendations from leading medical organizations in Canada and the United States:
The Physician-Patient Alliance for Health & Safety (PPAHS) released a clinical education podcast, “Using Capnography and Recognizing Respiratory Compromise Could Save Patient Lives.”
The podcast features an interview with Jenifer Lightdale, MPH, MD who is division chief, pediatric gastroenterology and chief quality officer at the Children’s Medical Center at the University of Massachusetts Medical School.
Millions of gastrointestinal endoscopy are performed each year in the US, with colonoscopies making up the majority of such procedures. Research conducted by Michael W. Jopling, MD and Qiu Jiejing published in BMC Anesthesiology concluded that capnography use associated with reduction of adverse outcomes during procedural sedation.
Their research sought to “estimate the incidence of pharmacological rescue events and death at discharge from an inpatient or outpatient hospitalization where [gastrointestinal endoscopic procedures] GEP was performed with sedation, and to determine if capnography monitoring was associated with reduced incidence of these adverse outcomes.”
Nursing recommendations from ARIN and AORN encouraged Sunnybrook Health Sciences Centre to monitor with capnography patients undergoing procedural sedation.
In a podcast with the Physician-Physician Alliance for Health Safety, Barbara McArthur, RN, BScN, CPN(C), an advanced practice nurse at Sunnybrook Health Sciences Centre in Toronto, Canada, discussed why Sunnybrook Health Sciences Centre decided to monitor with capnography.
By Lynn Razzano, RN, MSN, ONCC (Clinical Nurse Consultant, Physician-Patient Alliance for Health & Safety)
The American College of Emergency Physicians (ACEP) defines procedural sedation as:
“a technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function. Procedural sedation and analgesia (PSA) is intended to result in a depressed level of consciousness that allows the patient to maintain oxygenation and airway control independently.”