In 2011, ACEP formed the sedation task force to address procedural sedation in the ED by working with ED nursing colleagues, anesthesiology, and other stakeholders. The sedation task force published its recommendations for physician credentialing, privileging, and practice related to procedural sedation and analgesia in the ED in 2011.⁴ This update is intended to be used to develop hospital policy for the administration of analgesia, sedation, and anesthesia by emergency physicians. From the paper, it is clear that sedation and analgesia in the ED represents a unique skill set and that policies and procedures that define the various uses of analgesia and anesthesia require an interdisciplinary effort on the part of ED physicians and nursing.

Resolution of these limitations to our practice will allow us to provide sedation in a manner conducive to patient safety by tailoring treatment to the individual patient. Emergency physicians are uniquely qualified to provide all levels of analgesia/sedation and anesthesia (moderate to deep to general) and should be allowed to practice unencumbered.

Dr. O’Connor is professor, chair, and physician-in-chief of the department of emergency medicine at the University of Virginia Health System in Charlottesville, Va. He is also an emergency physician at the Culpeper Regional Hospital in Culpeper, Va., and is vice president of the ACEP Board of Directors.

References

1. Wendling P. CMS anesthesia policy altered after outcry. ACEP News. February 2011. Available at: http://www.acep.org/Content.aspx?id=79760. Accessed January 21, 2014.
2. American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Procedural Sedation and Analgesia. Clinical policy: procedural sedation and analgesia in the emergency department. Ann Emerg Med. 2014;63:247-258.
3. Centers for Medicare & Medicaid Services. CMS Manual System pub. 100-07 state operations provider certification: revised appendix A, interpretive guidelines for hospitals. December 2, 2011. Available at: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R74SOMA.pdf. Accessed January 21, 2014.
4. O’Connor RE, Sama A, Burton JH, et al. Procedural sedation and analgesia in the emergency department: recommendations for physician credentialing, privileging and practice. Approved June 2011. Available at: http://www.acep.org/assets/0/16/898/904/95333/cdc72351-3f53-470a-8705-98a18ff53298.pdf. Accessed January 21, 2014.