Procedural sedation and analgesia in the emergency department

Abstract

Emergency medicine as a medical specialty has come a long way since its evolution from the now obsolete “Casualty Department.” A prevalent challenge in the emergency department (ED) is safe and effective administration of anesthetic agents to a patient in pain or altered mentation without compromising their airway control and hemodynamics. Fear and unfamiliarity with the use of various anesthetic agents is the major stumbling block in this regard. Procedural sedation and analgesia (PSA) in the ED improve patient satisfaction, reduces physiological stress and allows for rapid return of consciousness after traumatic procedures while providing sedation, analgesia, and amnesia. PSA is a planned service which should be provided under strict monitoring with proper preanesthetic workup and emergency measures easily available. PSA strengthens the armament of the emergency physician, allowing a better understanding of pain control and sedation without resorting to general anesthesia.