A Standardised Procedure Chart

Propofol Sedation Chart

A few points worth emphasising:

  • One trained emergency physician for providing sedation, another ED doctor/practitioner for the procedure, and a trained nurse constitutes the team.
  • Concurrent use of an opiate will increase the chance of an adverse event. The author suggests you top up any opiate requirements your patient may have within a minute or two of meeting them and well before administering propofol.
  • Informed consent – verbal consent is sufficient, covering details of the sedative and the procedure itself.
  • It is worthwhile reminding yourself that what may be bread-and-butter emergency medicine to you, is a potentially horrific experience for your patient – cue, your bedside charm.
  • Equipment check, including suction
  • Have your suction turned on, and sited suitably on your trolley
  • Resus room facilities with capnography
  • Pre-oxygenate with a FiO2 as close to possible to 1.0 (high flow O2 via a bag-valve-mask) [14]
  • Start the procedure when the patient fails to respond to a verbal stimulus
  • Patient selection should be to include ASA patients 1and 2 only

Learning Bite

Capnography is a RCEM recommendation for propofol sedation.

Pre-oxygenate with a FiO2 as close to possible to 1.0 (high flow O2 via a non-rebreathe mask/mask with reservoir bag).