Procedural Sedation and Analgesia Facilitator – Expanded scope role for paramedics in the Emergency Department
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How to Cite

1.
Campbell S, Petrie D, MacKinley R, Froese P, Etsell G, Warren D, Kovacs G, Urquhart D, Magee K. Procedural Sedation and Analgesia Facilitator – Expanded scope role for paramedics in the Emergency Department. Australasian Journal of Paramedicine [Internet]. 2015Jul.16 [cited 2023Feb.2];6(3). Available from: https://ajp.paramedics.org/index.php/ajp/article/view/462

Abstract

Introduction

Procedural sedation and analgesia (PSA) is accepted as a standard of care in emergency departments (ED). PSA requires careful monitoring of a patient‟s cardio-respiratory status, and an ability to act immediately and appropriately in the event of any untoward event. The knowledge and skills necessary for this are a natural extension of the expertise of Advanced Care Paramedics (ACP). We report a series of PSA‟s conducted by ACPs over a 19 month period at a busy teaching hospital.

Methods

This is a retrospective descriptive study presenting data from a registry recording details of all cases of ACP-facilitated PSA conducted in our ED between August 1, 2004 and February 28, 2006. Baseline characteristics, indication for the procedure, medications used and adverse events are reported.

Results

1334 ACP-facilitated PSAs were conducted during the period. According to definitions used by this study, „desaturation‟- a SaO2 of < 90% at any time during the procedure in patients with an initial SaO2 of > 95% occurred in only 11 (0.9%) patients, and „hypotension‟ – systolic blood pressure (SBP) < 85 mm Hg in patients with an initial SBP > 100 mm Hg occurred in 0.6% of patients. One significant adverse event was recorded, that of pulmonary aspiration. Medications used for PSA included fentanyl (94.1%of cases), propofol (65.5%), midazolam (36.7%) and ketamine (2.2%).

Conclusion

PSA conducted in the ED by specifically trained ACPs is not associated with a significant number of adverse effects. This role should be recognized and subjected to further study.

https://doi.org/10.33151/ajp.6.3.462
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