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Posted by / 25-Dec-2019 14:48

Sedating agitated child ppt

There is a strong push to decrease the use of opioids; however, this should be the priority in the first 48–72 hours, where the focus should instead be on managing the acute illness and/or pain.Once the patient is over the hump, we can start de-escalating the opioid by moving to PRN boluses, a PCA, or even oral medications.The same data supporting the analgesia-first approach also demonstrated that up to 70% of patients will require an second sedative agent.I have found this to be true in the acute setting, and usually will use two agents when sedating newly-intubated patients.I tend to avoid midazolam infusions as much as possible, given the higher incidence of delirium.

These patients have a high morbidity and mortality, and present you with an even higher medico-legal risk from their behaviour, injuries they may have obtained, or from the underlying organic illness that is causing their adverse behaviour.These patients may self refer or be referred to the ED by concerned family members, other health professionals i.e., GPs, community mental health teams, or transported by police or paramedics in an aroused and agitated state for assessment, management and to rule of organic cause for their behaviour.Its is the responsibility of emergency clinicians to assess and manage these patients properly, with-out biases, and with the same thoroughness that you assess every patient with.It is important to remember that the CAM-ICU Score has limitations, such as in patients that are sedated, or in patients who have baseline confusion or poor cognition.This is not an insignificant number of patients in the ICU.

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This is a fascinating area of critical care medicine, although it can also be difficult and frustrating.