Urgent Sedation (Unscheduled Procedural Sedation) in the Emergency Department

Abstract

The emergency department (ED) commonly manages patients who require urgent/emergent painful or anxiety-provoking diagnostic or therapeutic procedures. Safe, appropriate, high-quality procedural sedation/analgesia (PSA) is an essential aspect of ED care of pediatric patients that increases the likelihood of procedural success and improves overall patient satisfaction. Emergency Medicine physicians are trained to stratify the risks and benefits of PSA and to manage any complications. Important factors to consider prior to PSA in the ED include patient selection, procedural complexity, procedural urgency, necessary personnel, and pharmacologic options. In general, performing simple procedures with few anticipated complications on patients with favorable cardiorespiratory anatomy and physiology without prior sedation complications is the ideal situation for PSA in the ED.