Hey folks Scott Weingard here and this is an MCrit podcast.

Today on the podcast we're going to do procedural sedation part four.

We've had three previous iterations on this and today part four is on the critically ill patient and we're going to be discussing a new regimen called Midiket with my partner in

crime Josh Farkas later on in the show. But let's talk about what the

context of this is. So in general most of the procedural sedations we do in the

emergency department are on relatively healthy patients.

Patient has a shoulder out, you know, some kind of joint reduction.

Or we're cardioverting a patient who is not moribund. We are doing most of this with the consideration only of

avoidance of things like respiratory depression because the patient's doing

okay otherwise before we

actually gave the procedural sedation. But there are going to be patients who are

super sick and yet still need some form of a sedation for a procedure.

And so that's what we're going to be talking about today.

Now, can we even do this in an emergency department or an ICU?

Well, let's deal with a former.

Most of the time, in most departments,

they'll do American Society of Anastasia,

ASA Class 1 or 2 people.

And these are people who are either healthy or they have mild

disease that's not really contributing to a significant threat to life or

particularly severe and then threes and fours are supposedly supposed to go to the operating room.

Now, first of all, that just doesn't happen in most hospitals.

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