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Documentation of Procedural Sedation by Emergency Physicians

Authors Veen M, van der Zwaal P, van der Linden MC

Received 31 December 2020

Accepted for publication 12 March 2021

Published 6 April 2021 Volume 2021:13 Pages 95—100


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Rajender R Aparasu

Mischa Veen,1 Peer van der Zwaal,2 M Christien van der Linden1

1Department of Emergency Medicine, Haaglanden Medical Center, The Hague, the Netherlands; 2Department of Orthopaedic Surgery, Haaglanden Medical Center, The Hague, the Netherlands

Correspondence: Mischa Veen
Department of Emergency Medicine, Haaglanden Medical Center, Post Office Box 432, The Hague, 2501 CK, the Netherlands
Tel +31 - 88 – 9797 900 extension 6868
Fax +31 - 70 3125976
Email [email protected]

Introduction: Patients presenting to the emergency department (ED) frequently require procedural sedation and analgesia (PSA) to facilitate procedures, such as joint reduction. Proper documentation of screening demonstrates awareness of the necessity of presedation assessment. It is unknown if introducing emergency physicians (EPs) at the ED improves presedation assessment and documentation. In this study the differences in documentation of ED sedation and success rates for reduction of hip dislocations in the presence versus absence of EPs are described.
Methods: In this retrospective descriptive study, we analyzed data of patients presenting with a dislocated hip post total hip arthroplasty (THA) shortly after the introduction of EPs. The primary outcome measure was the presence of documentation of presedation assessment. Secondary outcomes were documentation of medication, vital signs, and success rate of hip reductions.
Results: In the two-year study period, 133 sedations for hip reductions were performed. Sixty-eight sedations were completed by an EP. The documentation of fasting status, airway screening, analgesia use, and vital signs was documented significantly more often when an EP was present (respectively 64.9%, 80.3%, 37.4%, and 72.7%, all P < 0.001). There was no difference in success rate of hip reductions between the groups.
Conclusion: PSA in the ED is associated with superior documentation of presedation assessment, medication, and vital signs when EPs are involved.

Keywords: conscious sedation, emergency department, sedation, analgesia

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