Epidemiology of adverse effects of prehospital sedation analgesia

Am J Emerg Med. 2003 Oct;21(6):461-6. doi: 10.1016/s0735-6757(03)00095-0.

Abstract

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.

MeSH terms

  • Adult
  • Analgesia / adverse effects*
  • Analgesia / statistics & numerical data*
  • Comorbidity
  • Conscious Sedation / adverse effects*
  • Conscious Sedation / statistics & numerical data*
  • Emergency Medical Services / statistics & numerical data*
  • Female
  • France / epidemiology
  • Heart Arrest / epidemiology
  • Humans
  • Hypotension / epidemiology
  • Intubation, Intratracheal / statistics & numerical data
  • Male
  • Middle Aged
  • Nausea / epidemiology
  • Program Development
  • Prospective Studies
  • Quality Assurance, Health Care / methods
  • Respiratory Insufficiency / epidemiology
  • Transportation of Patients / statistics & numerical data
  • Vomiting / epidemiology