Procedural Sedation of Critically Ill Patients in the Emergency Department
Miner, Martel, Reardon, Meyer, Johnson, Biros:

Overview: This study sought to demonstrate that the rate of respiratory depression (RD) in critically ill patients (ASA class III and IV) would be similar for patients given Propofol or Etomidate.
 

Primary Endpoints: 1. RD assessed by End-Tidal CO2 (ETCO2) 2. Systolic Blood Pressure
 

Eligible Patients: Patients >18 years old seen in the Stabilization Room with ASA classification of III or IV.
 

Study Design: Prospective, randomized clinical trial.
 

Anticipated Benefits: none.
 

Potential Risks: Risks associated procedural sedation.
 

Research Associate’s Role:  Research Associates were responsible for setting up ETCO2 monitors on patients and for collecting Vitals and ETCO2 data during the course of the sedation.
 

Physician’s Role: none
 

Number of Patients Enrolled: n = 62, propofol = 31, etomidate = 31.
 

Results: No significant difference was observed between the two treatment groups with regard to the rate of RD as assessed by ETCO2.  The propofol group was observed to have a significantly greater decrease in systolic BP than the etomidate group.
 

Interpretation of Results / Affect on Clinical Practice:  Both etomidate and propofol appear to be safe agents for procedural sedation of ASA III and IV patients in the Stabilization Room.