Delivery of Agents for Procedural Sedation and Analgesia by Emergency Nurses

Here’s an ACEP statement I can appreciate: Delivery of Agents for Procedural Sedation and Analgesia by Emergency Nurses.

Approved by the ACEP Board of Directors April 2005 and the Emergency Nurses Association (ENA) Board March 2005
(Policy #400347, Approved April 2005)

The Emergency Nurses Association (ENA) and the American College of Emergency Physicians (ACEP) support the delivery of medications used for procedural sedation and analgesia by credentialed emergency nurses working under the direct supervision of an emergency physician. These agents include but are not limited to etomidate, propofol, ketamine, fentanyl, and midazolam.


  1. cardioNP says:

    With the JCAHO requirements for conscious sedation, does the patient getting procedural sedation then receive 1:1 nursing care?
    Theoretically, based on typical sedation guidelines, the nurse giving the drugs should be doing nothing other than administering sedation and monitoring the patient. Just curious how this issue is handled in an ER setting. We have discussed the difficulty in complying with the conscious sedation policy in the cath lab when there is one circulating nurse giving sedation, monitoring the patient and providing supplies and the other nurse is scrubbed assisting the MD.

  2. While I wouldn’t presume to speak for everyone in all circumstances, our nurses are indeed 1:1, and just doing meds and monitoring. If the doc needs help usually we’ll have a tech or two available to assist.