Annals of Emergency Medicine
Volume 55, Issue 3 , Pages 265-267 , March 2010

Should Capnographic Monitoring Be Standard Practice During Emergency Department Procedural Sedation and Analgesia? Pro and Con

  • Steven M. Green, MD

      Affiliations

    • Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, CA
    • Corresponding Author InformationAddress for correspondence: Steven M. Green, MD, Department of Emergency Medicine, Loma Linda University Medical Center, 11234 Anderson St, Loma Linda, CA 92354; 805-886-6593, fax 805-351-4697
    • ,
  • Jay Pershad, MD

      Affiliations

    • Department of Pediatrics, University of Tennessee Health Sciences Center and LeBonheur Children's Medical Center, Memphis, TN

References 

  1. Deitch K, Miner J, Chudnofsky CR, et al. Does ETCO2 monitoring during emergency department procedural sedation and analgesia with propofol decrease the incidence of hypoxic events? a randomized, controlled trial. Ann Emerg Med. 2010;55:258–264
  2. American Society of Anesthesiologists. Standards for basic anesthetic monitoring. http://www.asahq.org/publicationsAndServices/standards/02.pdfAccessed July 28, 2009
  3. Krauss B, Hess DR. Capnography for procedural sedation and analgesia in the emergency department. Ann Emerg Med. 2007;50:172–181
  4. Anderson JL, Junkins E, Pribble C, et al. Capnography and depth of sedation during propofol sedation in children. Ann Emerg Med. 2007;49:9–13
  5. Deitch K, Chudnofsky CR, Domenici P. The utility of supplemental oxygen during emergency department procedural sedation and analgesia with midazolam and fentanyl: a randomized controlled trial. Ann Emerg Med. 2007;49:1–8
  6. Deitch K, Chudnofsky CR, Domenici P. The utility of supplemental oxygen during emergency department procedural sedation and analgesia with propofol: a randomized controlled trial. Ann Emerg Med. 2008;52:1–8
  7. Burton JH, Harrah JD, Germann CA, et al. Does end-tidal carbon dioxide monitoring detect respiratory events prior to current sedation monitoring practices?. Acad Emerg Med. 2006;13:500–504
  8. Soto RG, Fu ES, Vila H, et al. Capnography accurate detects apnea during monitored anesthesia care. Anesth Analg. 2004;99:379–382
  9. Overdyk FJ, Carter R, Maddox RR, et al. Continuous oximetry/capnometry monitoring reveals frequent desaturation and bradypnea during patient-controlled analgesia. Anesth Analg. 2007;105:412–418
  10. Green SM, Krauss B. Supplemental oxygen during propofol sedation: yes or no [editorial]?. Ann Emerg Med. 2008;52:9–10
  11. Lightdale JR, Goldmann DA, Feldman HA, et al. Microstream capnography improves patient monitoring during moderate sedation: a randomized, controlled trial. Pediatrics. 2006;117:e1170–e1178
  12. Qadeer M, Vargo JJ, Dumot JA, et al. Capnographic monitoring of respiratory activity improves safety of sedation for endoscopic cholangiopancreatography and ultrasonography. Gastroenterology. 2009;136:1568–1576
  13. American College of Emergency Physicians. Clinical policy: procedural sedation and analgesia in the emergency department. Ann Emerg Med. 2005;45:177–196
  14. Pershad J, Wan J, Anghelescu D. Propofol versus pentobarbital based regimens for sedation during MR imaging in children: a randomized controlled trial. Pediatrics. 2007;120:e629–e636
  15. Pershad J, Gilmore B. Successful implementation of a radiology sedation service staffed exclusively by pediatric emergency physicians. Pediatrics. 2006;117:e413–e422

 Supervising editor: Michael L. Callaham, MD

 Dr. Callaham was the supervising editor on this article. Dr. Green did not participate in the editorial review or decision to publish this article.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Earn CME Credit: Continuing Medical Education is available for this article at: http://www.ACEP-EmedHome.com.

 Reprints not available from the authors.

 Publication date: Available online October 12, 2009.

PII: S0196-0644(09)01446-2

doi: 10.1016/j.annemergmed.2009.08.019

Annals of Emergency Medicine
Volume 55, Issue 3 , Pages 265-267 , March 2010

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