Epidemiology of adverse effects of prehospital sedation analgesia.
The aim of this study was to introduce a continuous monitoring of side effects related to sedation-analgesia in the field. A document was completed by physicians on board the ambulances for all prehospital interventions and checked daily by the medical staff. A total of 3605 interventions were evaluated over a 12-month period. Six hundred four patients undertook analgesia and/or sedation: group 1 (spontaneously breathing patients) n = 289 and group 2 (intubated-ventilated patients) n = 315. Sixty-four percent of patients received intravenous opioids in group 1. The anesthetic technique used for intubation was the rapid sequence induction in 70% of patients. Side effects were observed in 5.5% in group 1 (nausea: 2%, hypotension: 1%, hypoxemia: 1%) and 22% of patients in group 2 (hypotension-arrhythmia: 12%, cardiac arrest: 2%, difficult intubation: 5%, hypoxemia: 1%, pulmonary aspiration: 1%, laryngospasm/bronchospasm: 2%). No death was related to these medications. A close monitoring of side effects related to sedation-analgesia must be included in a quality program to improve patient safety in the field.
Department of Anesthesiology and Intensive Care, Beaujon University Hospital, 100 bd du Général Leclerc, 92110 , Clichy , France. agnes.ricard@bjn.ap-hop-paris.fr
Agnes
A
Ricard-Hibon
Charlotte
C
Chollet
Vanessa
V
Belpomme
Francois-Xavier
FX
Duchateau
Jean
J
Marty
D000328:Adult; D000698:Analgesia / Q000009:adverse effects* / Q000706:statistics & numerical data*; D015897:Comorbidity; D016292:Procedural Sedation / Q000009:adverse effects* / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006323:Heart Arrest / Q000453:epidemiology; D006801:Humans; D007022:Hypotension / Q000453:epidemiology; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology; D016730:Program Development; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods; D012131:Respiratory Insufficiency / Q000453:epidemiology; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014839:Vomiting / Q000453:epidemiology