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].