Interventions to improve emergency department postintubation sedation and analgesia: a systematic review

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2026
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Ranked #108 of 151 articles by views in American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

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Abstract
Abstract Purpose Mechanically ventilated emergency department (ED) patients require appropriate postintubation sedation and analgesia. Many investigators have published reports of their interventions to improve ED postintubation sedation and analgesia, but this work has not been systematically or critically evaluated. Methods We performed a systematic review of studies reporting original clinical research on interventions to improve ED postintubation sedation and analgesia. We identified studies for inclusion via a secondary analysis of a recent scoping review on ED postintubation sedation and analgesia. Two investigators independently abstracted data and graded study quality; a third investigator adjudicated any disagreements. Results We identified 22 studies meeting our inclusion criteria, of which 11 were conference abstracts. Meta-analysis was not pursued due to substantial heterogeneity, primarily in outcome definitions. Methods described included educational interventions (n = 18) and protocols, guidelines, order sets, and checklists (n = 16). Ten studies reported improvement in a prespecified primary outcome directly related to ED postintubation sedation. Outcome definitions were heterogeneous. Most interventions were not described in adequate detail to permit replication, and implementation science techniques and frameworks were identified in only 3 studies. Conclusion There is a small- to moderate-sized body of evidence to guide interventions to improve ED postintubation sedation and analgesia that is limited by heterogeneous outcome definitions and poor reporting of methods. Future work should include consistent, patient-centered outcome selection and rigorous reporting in adherence to guidelines on education and implementation research.
Reference Key
openalex_W7163873727 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Kevin Baumgartner, Kailey Denny, Emily Montgomery, Caitlyn Patton, Mikali Shedd, Julianne Yeary, Lauren H. Yaeger, R T Griffey, Brian M. Fuller
Journal American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
Year 2026
DOI
10.1093/ajhp/zxag173
URL
https://doi.org/10.1093/ajhp/zxag173
Keywords Keywords not found

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