Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.


PEM: Moderate Sedation

Randolph Cordle, MD

  • Selection of appropriate patients to sedate in the ED is as important as knowing how to give drugs. Remember your ASA classifications and assure you have both the capacity and equipment to recover the patient if there is an issue.
  • Give Ketamine slowly or they will become apneic (first 3-4 minutes is riskiest part).
  • Preoxygenate during your sedations and use ETCO2 as your early indicator and remember that a Flat line on ETCO2 is apnea or airway occlusion until proven otherwise. Don’t assume it is equipment failure.
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