Drug, Healthcare and Patient Safety (Apr 2021)
Documentation of Procedural Sedation by Emergency Physicians
Abstract
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 NetherlandsCorrespondence: Mischa VeenDepartment of Emergency Medicine, Haaglanden Medical Center, Post Office Box 432, The Hague, 2501 CK, the NetherlandsTel +31 - 88 – 9797 900 extension 6868Fax +31 - 70 3125976Email [email protected]: 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
