Procedural sedation is a common procedure performed in the emergency department and is a fundamental skill for emergency clinicians. With a wide variety of procedures and patient populations, procedural sedation can be systematically tailored to individual patients‘ needs, in order to optimize safety and efficacy.
Our recent evidence-based review Procedural Sedation and Analgesia in the Emergency Department distinguishes the various levels of sedation, provides insight on which patients are appropriate for procedural sedation, lists adjuncts that should be used, and reviews considerations for special populations.
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Here are a few key points:
- Depth of procedural sedation and analgesia (PSA) should be tailored to (1) the procedure, (2) the needs of the patient, and (3) the risk tolerance level.
- Consensus guidelines suggest an increased risk for adverse events in patients who are at extremes of age; have difficult neck, pharyngeal, or facial anatomy; and/or underlying disease.
- A patient should be asked about any previous experiences with sedation/anesthesia, medication allergies, current drug and alcohol use, medications, and underlying medical conditions that might augment drug metabolism.
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Last Updated on January 25, 2023
