Noninvasive positive pressure ventilation in procedural sedation.

Maintenance of spontaneous effective ventilations can present unique challenges to emergency physicians directing procedural sedation in patients with underlying anatomic or physiologic upper airway pathology. In a morbidly obese patient requiring electrical cradioversion, use of bilevel positive airway pressure facilitated deep sedation while averting any adverse respiratory complications. Noninvasive pressure support ventilation may present another emergency department adjunct for difficult procedural sedation cases.