04: Physiologic Monitoring in Procedural Sedation with Dr. Kevin Couloures

Society for Pediatric Sedation (SPS) Podcast

In this episode, we will be welcoming Dr. Kevin Couloures, a clinical associate professor of pediatrics at Stanford University and a pediatric critical care physician at the Lucile Packard Children’s Hospital and the California Pacific Medical Center in California. He has been with the Society for Pediatric Sedation for maNy years and is currently the vice-chair for the research committee and the Pediatric Sedation Research Consortium, the research arm of the Society for Pediatric Sedation.

The first patient case today is that of a four year old boy who needs a brain MRI for a focal seizure he had two days ago. The patient has no allergies and is previously healthy. He was sedated using a propofol bolus and is maintained on a propofol infusion in the MRI. It’s going to be a very insightful episode so don’t miss out.

Show Highlights

• Why the monitoring of a patient undergoing procedural sedation is so important (01:32)
• How to classify intended levels of sedation (03:08)
• The monitoring tools used in pediatric procedural sedation (05:00)
• Monitoring a child who is receiving mild, moderate or deep sedation (05:24)
• The ideal monitoring for a patient who just went through a procedure and is waiting for discharge (07:37)
• Role of pulse oximetry and capnography in procedural sedation (08:43)
• Bispectral (Bispectral index monitor) analysis during pediatric procedural sedation outside the operating room and its role (12:12)
• Recommended monitoring for short hematology oncology procedures such as lumbar punctures (13:24)
• Information available from the pediatric sedation research consortium about monitoring (14:40)
• Dr. Couloures’ personal clinical pearls regarding physiologic monitoring of patients undergoing procedural sedation (16:00)

Additional Resources

• www.Capnography.com
• Bispectral analysis during procedural sedation in the pediatric emergency department