The American College of Emergency Physicians reaffirmed that emergency physicians are qualified to administer procedural sedation in the emergency department in order to deliver faster and better care to their patients with a position paper released this summer.

Approved by ACEP’s Board of Directors in their June meeting, the paper outlines the process for credentialing emergency physicians with their hospitals.

“Emergency physicians are experts not only at administering procedural sedation, but also at rescuing patients with compromised airways,” said Dr. Sandra Schneider, ACEP President.

“Procedural sedation and analgesia is a core competency in emergency medicine and a daily part of emergency department practice. The best interests of our patients are served when emergency physicians provide the sedation required for time-sensitive, painful procedures, such as shoulder dislocations,” Dr. Schneider said.

Earlier this year, ACEP convened a task force to memorialize its position on procedural sedation and analgesia in the emergency department as a guide for hospitals. ACEP’s guidelines are supported by CMS and The Joint Commission, but hospitals individually decide who administers procedural sedation in their emergency departments.

“Requirements that emergency physicians work in teams of two to administer sedation and perform the procedure are unrealistic and unnecessary, given the training and skill of emergency nurses,” said the lead author of the paper, Dr. Robert E. O’Connor, who is also an ACEP Board member.

“Procedures that emergency physicians typically perform can be safely stopped so that the physician can give sedation and recovery their undivided attention,” he added. “ACEP’s position on procedural sedation is supported by scientific literature and very large clinical studies, which show no difference in quality or safety between emergency physician–directed sedation and that delivered by other specialists.”

ACEP also asserts that in the absence of a second physician, emergency nurses can and should participate in the administration of procedural sedation.

ACEP affirms the need for quality assurance programs in emergency departments that monitor procedural sedation and analgesia practice, track adverse events, ensure satisfactory documentation and compliance with protocols, and identify opportunities for improvement.

The paper is available online at acep.org and will be published in the October print edition of Annals of Emergency Medicine.