HSREB and Sedation Scale

Hi Gang,On reviewing the HSREB form I have a couple of additions:We should add Mike Peddle and Andrew McRae as co-investigatorsSection 7.7b asking about data off-site ; do we need to mention the transfer of data packages from STEGH to LHSC (question mainly for Shelley re what the board expectations are)?As to the Sedation Scoring, I have attached an interesting consensus document(see in box below) regarding a meeting dealing with the various options for measuring sedation and agitation in the ICU. I recall looking at some of these scales way back when we did the Prop/Midaz study, but reliability/validity data have emerged since as well as new scales. On looking at the scales in the comparative table on page 3 it occurs to me that the sedation portion of the Motor Activity Assessment Scale (MAAS) ie the first 4 categories, are exactly what we do clinically at the bedside when we are determining subsequent aliquots of sedative medication (ie no one does a glabellar tap). So I would suggest we use the sedation portion of the MAAS and make life a lot more simple. It would be kinda cool to do a reliability/validity study using the modified MAAS in the future. Waddayu think?As to the frequency of dosing, my apologies to you, Amit. The dosing is easily given q30-60 secs as we can still do VS’s q 2 mins independent of that. With a simpler sedation score we can also do those at a 60 sec interval.Let me know what you think. I will also post this on the BB to make the discussion flow a little more smoothly.Cheers,Greg

Hi Shelley,Seems the reviewer was less than thorough in reading our submission as they asked for things that were clearly included already. Having said that, you’ve done a great job, as usual. I would expand the title to “Ketamine plus Propofol for Procedural Sedation in the Emergency Department: A Feasibility Study” (or “Pilot Study”) just to avoid any misunderstanding regarding our methodological intentions.If it becomes a point of contention, we can always move the question regarding previous alcohol and drug use to the data sheet.The pocket card should include a very brief, point form list of the following:Inclusion/Exclusion criteriadosing of each drugcommon complications ie, burning at iv site, hypotension, apnea/hypoxia, emergence reaction, vomitingIf anyone has other suggestions as to what the pocket card should contain, please add your comments.When can we expect to get a response? We should plan an info email for those docs who stated they would participate in Andrew’s survey. Have we sent a second survey to increase our response rate? We can also enquire as to who needs a session and set up an info session for those folks.Cheers,Greg