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2011美国急诊科游离镇静临床实践指南

2022-03-08 00:08:19 来源: 陇南 咨询医生

Thedissociativeagentketaminehasbeenthesinglemostpopularagenttofacilitatepainfulemergencydepartment(ED)proceduresinchildrenfornearly2decades.Currentketamineprotocols,includingindications,contraindications,anddosing,arefrequentlybasedonawidelycited2004clinicalpracticeguideline,whichinturnwasanupdateofa1990protocol.4Thislatterarticlewascitedin1999asan“exampleofcompliance”byTheJointCommission.The2004guideline,however,isnowsubstantiallyoutofdateandinneedofrevisionbecausesubsequentketamineinvestigationshequestioned,disproved,orrefinedseveralofitsassertionsandrecommendations.Duringthissameperiod,therehasalsobeensufficientEDresearchinstosupportexpansionofketamineusebeyondchildren.Inaddition,animalresearchdescribingneurotoxicitywithketamineraisesimportantnewquestionsthatmustbeconsideredandfurtherinvestigatedinhumans.Todescribethebestailableevidenceandperspectivesaboutoptimaldissociativesedationpractice,wereviewedthenewerketamineliteratureandupdatedthe2004clinicalpracticeguideline.

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