Feasibility of single- vs two-physician procedural sedation in a small community emergency department

Understanding the Process of Procedural Sedation for Orthopedic Injuries in the Pediatric Emergency Department

Objective:

To establish a procedural sedation (PS) time line for patients in the pediatric emergency department (PED) with orthopedic injuries.

Methods:

Retrospective review of patients requiring PS for orthopedic injuries. Process times were collected. Ten percent of encounters were co-reviewed. Interrater reliability and descriptive statistics were calculated.

Results:

A total of 189 patients were included. Co-abstracted data demonstrated excellent agreement. The median time to PS and length of stay (LOS) were 214 (interquartile range [IQR]: 160-282) and 320 (IQR: 257-402) minutes, respectively.

Conclusion:

Patients with orthopedic injuries requiring PS experience prolonged PED visits. Interventions should target safely reducing the time to PS and LOS.

Unscheduled Procedural Sedation: A Multidisciplinary Consensus Practice Guideline

The American College of Emergency Physicians (ACEP) organized a multidisciplinary effort to create a clinical practice guideline specific to unscheduled, time-sensitive procedural sedation, which differs in important ways from scheduled, elective procedural sedation. The purpose of this guideline is to serve as a resource for practitioners who perform unscheduled procedural sedation regardless of location or patient age. This document outlines the underlying background and rationale, and issues relating to staffing, practice, and quality improvement.