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The original scoring system was developed before the invention of pulse oximetry and used the patient's colouration as a surrogate marker of their oxygenation status. A modified Aldrete scoring system was described in 1995 [2] which replaces the assessment of skin colouration with the use of pulse oximetry to measure SpO 2.
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.
The first PICU in the United States is a topic often debated. Currently, Fuhrman’s Textbook in Pediatric Critical Care lists Pediatric Critical Care Unit at the Children’s Hospital of District of Columbia in Washington, DC, dating back to 1965, as the first pediatric critical care unit in the U.S.A. Medical Director was Dr. Berlin. [6]
Advanced Pediatric Life Support (APLS) is a program created by the American Academy of Pediatrics and the American College of Emergency Physicians to teach health care providers how to take care of sick children.
Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane , diethyl ether , propofol , etomidate , ketamine , pentobarbital , lorazepam and midazolam .
It is however mostly used in mechanically ventilated patients in order to avoid over and under-sedation. Obtaining a RASS score is the first step in administering the Confusion Assessment Method in the ICU (CAM-ICU), [4] a tool to detect delirium in intensive care unit patients. The RASS is one of many sedation scales used in medicine.
Close monitoring by the anesthesia provider will sometimes be provided, to help keep the patient comfortable during a medical procedure, along with other drugs to help relax the body. It can also help control breathing, blood pressure, blood flow, and heart rate and rhythm, when needed. [1] There are four levels of sedation by anesthesia.
This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents ( aspiration ).