Inclusion:
Patients of all age with emergent/urgent condition that require pain +/or anxiety management to accomplish interventional or diagnostic procedure
High-risk patients (cardiopulmonary d/o, multiple/head trauma, CNS depressant) w understanding that these patients are at increased risk of complications from procedural sedation and analgesia.
Exclusion:
Inhalational anesthetics
Analgesia for pain control without sedatives
Sedation solely for anxiolysis and behavioral emergencies
Intubated patients
Level A:
Ketamine safe for children. Propofol safe for children and adults for sedation in analgesia in ED.
Level B:
Do not delay procedural sedation in adults or pediatrics in the ED based on fasting time. Preprocedural fasting for any duration has not demonstrated a reduction in risk of emesis or aspiration
Capnography may be used as adjunct to pulse ox and<unk>  assessment to detect hypoventilation and apnea earlier than pulse ox +/or<unk>  assessment alone
Etomidate safe to adults. Combination of propofol and ketamine safe for children and adults.
Level C:
During procedural sedation and analgesia, a nurse or other qualified individual should be present for continuous monitoring, in addition to the provider performing procedure. Physicians who are working or consulting in ED should coordinate procedures.
Ketamine safe for adults. Alfentanil safe for adults. Etomidate safe for children.
Inhalational anesthetics
Analgesia for pain control without sedatives
Sedation solely for anxiolysis and behavioral emergencies
Intubated patients
Ketamine safe for children. Propofol safe for children and adults for sedation in analgesia in ED.
Do not delay procedural sedation in adults or pediatrics in the ED based on fasting time. Preprocedural fasting for any duration has not demonstrated a reduction in risk of emesis or aspiration
Capnography may be used as adjunct to pulse ox and<unk>  assessment to detect hypoventilation and apnea earlier than pulse ox +/or<unk>  assessment alone
Etomidate safe to adults. Combination of propofol and ketamine safe for children and adults.
During procedural sedation and analgesia, a nurse or other qualified individual should be present for continuous monitoring, in addition to the provider performing procedure. Physicians who are working or consulting in ED should coordinate procedures.
Ketamine safe for adults. Alfentanil safe for adults. Etomidate safe for children.
ACEP clinical policies
Sign out tools
Reexamination sample documentation
Mass casualty incident triage
STOPP/START criteria
Denver screening criteria
Critical care documentation
Clinical decision rules list