By Dr Malik

1. Procedural Sedation in Adults Malik AL-Rawahi

42. Sexual assault examination Cardioversion Fentanyl (IV) Ketamine (IM/IV) Chest tube placement Methohexital (IV) plus: or Burn debridement Etomidate (IV) or Fentanyl (IV) Fracture/joint reduction High anxiety Evidence now exists to support the use of any of these agents. However, there are far more data supporting the safety and efficacy of midazolam/fentanyl and ketamine for emergency department use than the other regimens. In children, administer ketamine IV or IM with atropine or glycopyrrolate. In adults, administer ketamine IV preceded by midazolam IV. Propofol (IV) or Midazolam and Abscess irrigation and drainage High pain Slit lamp examination Eye irrigation Simple foreign body removal Nitrous oxide (IV, PO, IN, PR) Lumbar puncture High anxiety These procedures generally do not require more than moderate sedation , and analgesia can usually be provided using local or topical anesthesia. Ketamine (IM) Midazolam Simple laceration repair Low pain Midazolam (IV) Etomidate (IV) Echocardiography IV access is often not required in these patients. Methohexital given rectally is likely safer than methohexital or etomidate given IV. Midazolam does not consistently render children motionless. Methohexital (IV) Methohexital (PR) Radiologic imaging Noninvasive Comments Alternatives Recommendation Common Emergency Department Examples Procedure Type

49. Thank You