Sedating critically ill ED patients can be challenging.
Excessive sedation is associated with a prolonged duration of mechanical ventilation, ICU LOS, and may increase mortality.
Important pearls to consider when managing these patients include:
Prioritize pain management first - may reduce the need for sedative medications
When possible, target a calm and interactive patient shortly after intubation - consider adding a atypical antipyschotic with propofol or dexmedetomodine
Use a validated tool (i.e., RASS) to dose opioids and sedative medications
Avoid continuous infusions of benzodiazepines
References
Metha S, et al. What's New in Intensive Care: Ten Tips for ICU Sedation. Intensive Care Med 2017. [epub ahead of print].
