Members weigh in on physicians’ use of conscious sedation versus procedural sedation in the ED

ACEP Councillors were surveyed about the use of conscious sedation/procedural sedation. In next month’s issue, we’ll look at what these results mean for emergency physicians.

January 2014 ACEP Now Council Survey

1. Is your ability to provide conscious/procedural sedation significantly restricted at your hospital (i.e. not allowed to practice as you would like and/or limitations set by policy)?

Response:
Yes – 43.8%
No – 56.2%

 2. If so, are the restrictions from the department of anesthesia?

Response:
Yes – 53.9%
No – 46.1%

3. If so, are the restrictions from limitations placed on nursing scope of practice (i.e. nurses prohibited from delivering certain medications IV push)?

Response:
Yes – 85.5%
No – 14.5%

4. Can you use propofol for conscious/procedural sedation?

Response:
Yes – 84.8%
No – 15.2%

5. Can you use ketamine for conscious/procedural sedation?

Response:
Yes – 94.3%
No – 5.7%

6. If so, can you administer ketamine IM in pediatrics without an IV in place?

Response:
Yes – 79.6%
No – 20.4%

7. Do you have to apply for conscious/procedural sedation as a non core privilege?

Response:
Yes – 67.1%
No – 32.9%

8. Do you have to take a “merit badge” course (i.e. BLS, ACLS, PALS) in order to obtain privileges for conscious/procedural sedation?

Response:
Yes – 34.8%
No – 65.2%

9. Do you have to take a hospital developed test to in order to obtain privileges for conscious/procedural sedation?

Response:
Yes – 56.1%
No – 43.9%

10. Have you ever been forced to provide substandard care due to limitations or restrictions placed on your ability to provide conscious/procedural sedation?

Response:
Yes – 36.2%
No – 63.8%