Toracostomía cerrada bajo sedación en el servicio de urgencias. Revisión de tema

Toracostomía cerrada bajo sedación en el servicio de urgencias. Revisión de tema Thoracostomy Under Sedation In The Emergency Service. Topic Review

Published 2021-01-03


https://doi.org/10.30554/archmed.21.1.3536.2021
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Vol. 21 No. 1 (2021): .
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Mora Rodríguez, J. L. ., Herrera Cañón, J. C., Hoyos Valencia, V. ., & Ortega Narváez, M. . (2021). Toracostomía cerrada bajo sedación en el servicio de urgencias. Revisión de tema: Thoracostomy Under Sedation In The Emergency Service. Topic Review. Archivos De Medicina (Manizales), 21(1), 203-214. https://doi.org/10.30554/archmed.21.1.3536.2021
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Mora Rodríguez, J. L. ., Herrera Cañón, J. C., Hoyos Valencia, V. ., & Ortega Narváez, M. . (2021). Toracostomía cerrada bajo sedación en el servicio de urgencias. Revisión de tema: Thoracostomy Under Sedation In The Emergency Service. Topic Review. Archivos De Medicina (Manizales), 21(1), 203-214. https://doi.org/10.30554/archmed.21.1.3536.2021

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José Luis Mora Rodríguez
Jefe servicio de Urgencias SES Hospital de Caldas
https://orcid.org/0000-0002-0249-9402 ORCID
Jhon Camilo Herrera Cañón
Servicio de Urgencias SES Hospital de Caldas,
https://orcid.org/0000-0003-3403-3540 ORCID
Valentina Hoyos Valencia
Servicio de Urgencias SES Hospital de Caldas, Manizales, Colombia. 
https://orcid.org/0000-0001-6441-9570 ORCID
Marisol Ortega Narváez
https://orcid.org/0000-0002-5841-5562 ORCID
Show authors biography

José Luis Mora Rodríguez,

Especialista en Medicina de Urgencias. Coordinador especialización en Medicina de Urgencias, Universidad de Caldas, Vicepresidente Asociación Colombiana de Especialistas Medicina de Urgencias y Emergencias. Jefe servicio de Urgencias SES Hospital de Caldas, Manizales, Colombia.  

Jhon Camilo Herrera Cañón,

Médico General, Servicio de Urgencias SES Hospital de Caldas, Manizales, Colombia. 

Valentina Hoyos Valencia,

Médica General, Servicio de Urgencias SES Hospital de Caldas, Manizales, Colombia. 

Marisol Ortega Narváez

Médica General. Clínica Santillana, Caldas, Manizales, Colombia. 

Trauma constitutes one of the main challenges in terms of public health in the world. According to the WHO, it causes about five million deaths per year, chest trauma is one of the most frequently occurring injuries, reporting up to 90-96% of penetrating injuries with mortality close to 30%.

Thoracostomy is a procedure frequently performed in the emergency department, however, it is a painful and uncomfortable procedure, and there could be difficulties while it is done.

It is required to find the available information about how safe a thoracostomy is under sedation is and determine its usefulness in the emergency department; learning the levels of sedation, and depending of the procedure the patient needs, determine the level of sedation the patient has to induced into. 

The use of medications for analgesia and sedation in the emergency room is aimed to the effective and safe control of pain and anxiety as well as to avoid movements of the patient to reduce complications. This review considers medications such as ketamine, propofol, morphine, hydromorphone, fentanyl, etomidate, midazolam and the best combinations of these medications to carry out sedation for emergency thoracostomy. However, there is not a therapeutic strategy applicable to all patients, therefore each patient has to be analyzed individually.

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