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Sedation practices in Denmark

Introduction

The interest of sedation in ICU patients has been increasing the last 10 years. The benefits of protocol-driven care have become evident.

Objective

The aim of the study was to describe current practice of sedation in Danish ICUs addressing the use of protocols and the wake-up call test.

Methods

Two doctors and two nurses from all the Danish adult ICUs were identified to participate in an Internet-based survey. These persons answered questions about sedation practices, use of sedation scorings systems, and withdrawal symptoms.

Results

Twenty-nine (82.9%) out of a total of 35 possible hospitals answered, including 113 (57.7%) answers out of a total of 196 possible answers. Ninety-seven per cent of the physicians were specialists in anaesthesiology. Eighty-seven per cent of the nurses were certified intensive care nurses. Forty-seven per cent were from university hospitals. Twenty-six per cent had a sedation protocol, 37% of the physicians and 14% of the nurses. Only one-third of the ICUs had a protocol for sedation. Sixty-eight per cent having a protocol used it always or often, whereas 32% never use it. Sixty-seven per cent had a sedation scoring system in their departments. The scoring systems used was: Ramsay 49%, Sedation Agitation Score 10% and own (locally made) scoring system 41%. Twenty-two per cent answered that the scoring systems was always used, 58% often and in 20% the scoring systems was seldom used. Forty per sent use the 'wake-up call' test, 63% physicians and 37% nurses. Sixty per cent answered 'no we do not use' the wake-up call test, 47% physicians and 53% nurses. Withdrawal symptoms were experienced more than three times as frequently by nurses compared with physicians (31% vs 9%). Five times as many experienced withdrawal symptoms in the group not having a sedation and analgesia protocol (84% vs 16%).

Conclusion

There is still a great educational potential for improving the use of sedation protocols and implementing sedation scoring systems and the wake up test in Danish ICUs. This potential could perhaps reduce the incidence of withdrawal symptoms. Effort should also be placed in implementing the sedation protocol in the ICU, illustrated by the differences in numbers of doctors and nurses having a sedation protocol.

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Espersen, K., Skielboe, M. & Jensen, T. Sedation practices in Denmark. Crit Care 11, P421 (2007). https://doi.org/10.1186/cc5581

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Keywords

  • Emergency Medicine
  • Scoring System
  • Current Practice
  • Care Nurse
  • Withdrawal Symptom