References

Burton JH, Harrah JD, Germann CA, Dillon DC. Does end-tidal carbon dioxide monitoring detect respiratory events prior to current sedation monitoring practices?. Acad Emerg Med. 2006; 13:(5)500-4

Miner JR, Heegaard W, Plummer D. End-tidal carbon dioxide monitoring during procedural sedation. Acad Emerg Med. 2002; 9:(4)275-80

Academy of Medical Royal Colleges. Standards and guidelines. Safe sedation practice for healthcare: procedures, standards and guidance. 2013. http://tinyurl.com/ydbomujg

An essential element of safe monitoring

02 December 2017
Volume 7 · Issue 3

The prompt treatment of pain and the control of seizures are essential parts of paramedic practice. This has resulted in paramedics, in many parts of the world, being empowered to administer opiate analgesia and benzodiazepines. These drugs are increasingly being supplemented by Ketamine—both as an analgesic agent, as well as for its sedatory properties.

While these drugs are deemed to be safe for pre-hospital administration, their use does represent a risk of drug-induced respiratory depression. This has resulted in a number of ambulance services also providing reversal agents such as Naloxone (primarily provided for reversal of recreational over-dose) and Flumazenil for use in iatrogenic-induced respiratory depression. However, these drugs are not without side-effects—most notably, the reversal of the analgesic effects of opiates and blocking the anti-convulsion properties of benzodiazepines. Regardless of whether reversal agents are required, their use would still require that the paramedic can accurately identify that respiratory depression has occurred.

Subscribe to get full access to International Paramedic Practice

Thank you for visiting International Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

What's included

  • CPD Focus

  • Develop your career

  • Stay informed