I read the article “Criteria for sedation of psychiatric patients for air transport in British Columbia” [BCMJ 2009;51:346 [2]] with great interest. I have received such patients when I was working as an in-patient psychiatrist at BC Children’s Hospital.
On page 349 the authors state, “However, to date, BCAS has not documented any adverse events due to over-sedation.” I had received a patient who was clearly suffering adverse effects, and who was unable to fully recover for several days. He was delusional at first from the sedation, not from his psychiatric condition.
I wrote to Dr Wheeler, one of the authors, and was informed that their definition of adverse events is “airway compromise, aspiration of secretions, or vomiting” so my patient did not fulfill those criteria. I think this article is misleading and should have stated that no patients had an airway compromise or aspiration.
I think the doctors of British Columbia need to know how sedated their patients are going to be, and that this can be a problem, before they make the decision to transport a patient by BCAS.
—Geoffrey Ainsworth, MD
Vancouver