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It is the official publication of the Society of Critical Care Medicine and is published by Lippincott Williams & Wilkins. The Society of Critical Care Medicine produces a podcast for critical care clinicians, The iCritical Care Podcast. [2] The Society has participated in developing guidelines and policies with: Canadian Journal of Anesthesia [3]
With the growth of hospitals with PICUs in the 1980s, the American Academy of Pediatrics (AAP) and the pediatric section of the Society of Critical Care Medicine (SCCM) set forth guidelines in 1993 for PICUs. [9] Since the establishment of those guidelines, both the number of PICUs and number of PICU beds has been steadily increasing in the US.
Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient. The overall goal is to induce a decreased level of consciousness while maintaining the patient's ability to breathe on their own.
A chemical restraint is a form of medical restraint in which a drug is used to restrict the freedom or movement of a patient or in some cases to sedate the patient. Chemical restraint is used in emergency, acute, and psychiatric settings to perform surgery or to reduce agitation, aggression or violent behaviours; [a] it may also be used to control or punish unruly behaviours. [2]
Sedation scales are used in medical situations in conjunction with a medical history in assessing the applicable degree of sedation in patients in order to avoid under-sedation (the patient risks experiencing pain or distress) and over-sedation (the patient risks side effects such as suppression of breathing, which might lead to death).
The presence of an endotracheal tube and mechanical ventilation alone are not indications of continuous sedation and coma. Only certain conditions such as intracranial hypertension, refractory status epilepticus, the inability to oxygenate with movement, et cetera justify the high risks of medically induced comas.
In 1981, the Society of Critical Care Medicine, SCCM, which express guidelines and standards for adult critical care, recognized pediatric critical care as unique from adults and created a separate section within the SSCM for their care. [10]
Mild or moderate sedation can be induced with medications such as midazolam (a benzodiazepine with sedating, amnesiac qualities), fentanyl (an opioid), or propofol (a sedative/general anesthetic, depending on dosage). Children are anesthetized. Adults are sometimes anesthetized as well if moderate sedation is unsuccessful. [citation needed]