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Sedating The Critically Ill Patient
- 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].