Guideline sources The following summarized guidelines for the management of procedural sedation are prepared by our editorial team based on guidelines from the American College of Emergency Physicians (ACEP 2014). 1 Guidelines 1. Medical management General principles: avoid delaying procedural sedation in adults or pediatrics in the emergency department based on fasting time. Preprocedural fasting for any duration has not demonstrated a reduction in the risk of emesis or aspiration when administering procedural sedation and analgesia. D Ketamine, propofol and etomidate: consider propofol for procedural sedation and analgesia in children and adults in the emergency department. B Show 2 more Capnographic monitoring: consider capnography as an adjunct to pulse oximetry and clinical assessment to detect hypoventilation and apnea earlier than pulse oximetry and/or clinical assessment alone in patients undergoing procedural sedation and analgesia in the emergency department. C References 1. Godwin SA, Burton JH, Gerardo CJ et al. Clinical policy: procedural sedation and analgesia in the emergency department. Ann Emerg Med. 2014 Feb;63 2 247 58.e18. Open https://web.pathway.md/diseases/recOFoqx5pjvCYizR 1/2 6/29/23, 11:30 PM Procedural sedation Pathway 2. Early DS, Lightdale JR, Vargo JJ nd et al. Guidelines for sedation and anesthesia in GI endoscopy. Gastrointest Endosc. 2018 Feb;87 2 327 337. Open 3. Ian Ferguson, Anthony Bell, Greg Treston et al. Propofol or Ketofol for Procedural Sedation and Analgesia in Emergency Medicine-The POKER Study: A Randomized Double-Blind Clinical Trial. Ann Emerg Med. 2016 Nov;68 5 574 582.e1. Open 4. Stephan M Jakob, Esko Ruokonen, R Michael Grounds et al. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA. 2012 Mar 21;307 11 1151 60. Open 5. American Society of Anesthesiologists. Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018 A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. Anesthesiology. 2018 Mar;128 3 437 479. Open https://web.pathway.md/diseases/recOFoqx5pjvCYizR 2/2