Dating of propofol problems updating flash player on mac

19-Dec-2016 08:51

Propofol is frequently used for procedural sedation in the ED and is considered to be safe when administered by trained personnel.

Typical initial dosage of propofol used for procedural sedation is 1mg/kg intravenously, followed by 0.5mg/kg every 3min titrated to the desired level of sedation.

A 23-year-old man presented to the ED with pain and swelling of his left foot secondary to a work-related accident. The patient was a smoker and denied drug allergies, use of medications or illicit drugs. His temperature was 36.7o C, heart rate 88 beats/min, blood pressure 133/90 mm Hg, respirations 20 breaths/min, and oxygen saturation by pulse oximetry (Sp O2) 100% on room air.

His weight was 66 kg and his physical examination was unremarkable, except for left foot swelling and tenderness.

While not the primary focus of the present report, the care of the reported patient could have been alternatively facilitated by using a regional nerve block, thus avoiding exposure to systemic procedural sedation, its attendant risks, and the associated need for additional monitoring.

He tolerated the procedure well, adequately maintaining his airway.

His Sp O2 was 95% throughout the procedure, on oxygen at 15 liters per minute through a non-rebreather mask.

However, as noted by others, regional anesthesia requires special training and expertise, and may not be consistently available.

Our findings underscore the variability in clinical practice among emergency medicine clinicians and the potential for improvement.

While not the primary focus of the present report, the care of the reported patient could have been alternatively facilitated by using a regional nerve block, thus avoiding exposure to systemic procedural sedation, its attendant risks, and the associated need for additional monitoring.

He tolerated the procedure well, adequately maintaining his airway.

His Sp O2 was 95% throughout the procedure, on oxygen at 15 liters per minute through a non-rebreather mask.

However, as noted by others, regional anesthesia requires special training and expertise, and may not be consistently available.

Our findings underscore the variability in clinical practice among emergency medicine clinicians and the potential for improvement.

Negative pressure pulmonary edema due to airway obstruction may complicate administration of central nervous system suppressants.