چاپ صفحه |  صفحه نخست سامانه |  چکیده مقاله |  نویسندگان |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| The video by Krauss et al. on procedural sedation and analgesia in children (April 10 issue)1 was thorough and detailed. However, I am very concerned that 45 seconds into the video an injection into intravenous tubing pushes air bubbles toward the patient. The potentially disastrous consequences of air in intravenous lines are well known, particularly in children with intracardiac shunts. William A. Scott, M.D. UT Southwestern Medical Center Dallas, TX william.scott@childrens.com No potential conflict of interest relevant to this letter was reported. 1. Krauss BS, Krauss BA, Green SM. Videos in clinical medicine: procedural sedation and analgesia in children. N Engl J Med 2014;370(15):e23. DOI: 10.1056/NEJMc1405676 To the Editor: Pediatric patients have limited respiratory reserve and are susceptible to the rapid development of hypoxemia. The emergency equipment mentioned by Krauss et al. does not address the management of an unanticipated difficult or impossible bag-mask–ventilation scenario or the use of emergency airway devices, including a laryngeal mask airway of the appropriate size,1 an endotracheal tube, and a laryngoscope, which should also be available. Furthermore, the authors state that the administration of supplemental oxygen before and during sedation renders pulse oximetry ineffective with regard to early warnings of respiratory depression and recommend the use of capnography when supplemental oxygen is used. These aspects of the video could lead to the misconception that the observation of ineffective pulse oximetry in the early detection of hypoventilation is related to the administration of supplemental oxygen or that capnography cannot be used if supplemental oxygen is not used simultaneously |
| نویسنده | نفر چندم مقاله |
|---|---|
| صمد اسلام جمال گلزاری | اول |
| حسن سلیمانپور | دوم |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| L-NEJM-Procedural sedation.pdf | 1398/09/12 | 297600 | دانلود |
