Sedation for ventilation

Abstract

SummaryA retrospectiue surrey ofthe sedation requirements of the last 50 patients needing ventilation in a prouincial Intensiue Therapy Unit ( I T U ) showed a wide uariation in regimes used.The results were more random than expected: some patients were gioen six drugs for control oft)entilation. There was greater reliance on pancuroniurn than anticipated.Patients' requirements oaried greatly. as did each individual's daily requirements. The need to ensure adequate sedation is emphasised.

Health care professionals’ knowledge of commonly used sedative, analgesic and neuromuscular drugs: A single center (Rambam Health Care Campus), prospective, observational survey

“…Immediate implementation of educational programs was recommended. [7][8][9] While in the 1980s and 1990s deep sedation and neuromuscular blockade were the common practice, newer guidelines emphasize the analgesia-first concept, the benefits resulting from a lighter level of sedation and the importance to avoid unnecessary muscular blockade. [14] Another important factor influencing current clinical practice is the fact that in many hospitals mechanically ventilated patients are not managed exclusively in the ICU, but also in surgical and medical wards.…”

“…It is one of the biggest fears people have when they are about to undergo a medical procedure. [7,17] The misconception rate regarding the pharmacologic effects of benzodiazepines and propofol was higher among physicians, compared to nurses, while physicians had better knowledge about opiates and muscle relaxants. Senior physicians scored better than their younger colleagues.…”

“…Numerous studies published in the 1980's, found that a significant number of critically ill, mechanically ventilated patients might have been treated with muscular blockage agents without concomitant narcotics or sedatives. [7,8] In 1989, Loper at al. surveyed the pharmacological knowledge of ICU physicians and nurses regarding the analgesic and anxiolytic effects of narcotics, benzodiazepines and neuromuscular blockers.…”