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Preventing Unfavorable Outcomes with Standardized Moderate Sedation Practices

December 12, 2023
December 12, 2023

This blog is based on a recent HealthStream webinar entitled “Preventing Unfavorable Outcomes with Standardized Modern Sedation Practices.” The webinar was moderated by Daniel Pawlus, HealthStream’s Senior Manager of Digital Events and featured presenters:

  • David P. Martin, MD, PhD, Vice President for Scientific Affairs, American Society of Anesthesiologists (ASA)
  • Eunice “Nici” Singletary, MD, FACEP, Co-Chair, American Red Cross Scientific Advisory Council
  • Luther Cale, Vice President, Clinical Programs, HealthStream

The shortage of anesthesiologists has reached a critical point and it requires new and creative solutions of healthcare leaders. Recently, there has been an emergence of moderate sedation procedures that are being performed by non-anesthesiologists outside of the operating room. While it is a lifeline for patients, it is important to ensure that providers administering moderate sedation have received the best education on the topic.


Procedural Sedation Education – Content That You Can Trust

Dr. Singletary began by describing the role of the American Red Cross Scientific Advisory Council (ARCSAC). ARCSAC is an independent advisory group that consists of about 60 physicians, paramedics, nurses, and other healthcare professionals who evaluate emerging scientific evidence related to resuscitation, disaster medicine, first aid, and aquatics. After the evidence is reviewed and summarized, the council provides the American Red Cross with recommendations regarding program content. ARCSAC includes experts from every field including adult and pediatric emergency medicine, critical care, trauma surgery, and others; many of which use procedural sedation. ARCSAC is also focused on the science of education. They wanted to be sure that they were using optimal education methods to teach this content.


Procedural Sedation Education - What Is Driving the Need?

Dr. Singletary shared that there had been a virtual revolution over the last 10 to 20 years in how physicians approach performing procedures that can provoke anxiety or produce pain. “Procedural sedation allows us to manage a patient’s pain and anxiety in order to facilitate therapeutic and diagnostic interventions,” said Dr. Singletary. Procedural sedation makes it easier for parents of pediatric patients as well and makes it less likely that adult patients will avoid certain medical and dental procedures due to concerns about pain. Dr. Singletary also shared that there has been a corresponding interest from patients seeking procedural sedation for procedures where sedation may not have been offered just a few short years ago. This has resulted in a mismatch between the supply and demand for procedural sedation as there are simply not enough anesthesiologists to meet the increasing demand.


Procedural Sedation Education for Non-Anesthesiologists

While anesthesiologists are well-educated on procedural sedation, other healthcare practitioners will now need to learn procedural sedation practices. The presenters pointed out that there is currently quite a bit of variance in how this training is delivered with facilities relying on seminars and homegrown courses. This has resulted in very little consistency in the training. “Providing consistent, safe education to our colleagues that do procedural sedation is the right thing to do for the patients, for the hospital and for the anesthesia department,” said Dr. Martin. 

The Red Cross Sedation program includes modules for adult and pediatric patients. The American Red Cross Procedural Sedation courses were developed in collaboration with ASA and include the most current clinical information and procedural sedation best practices.

Presenters also addressed the importance of understanding the differences between adult and pediatric patients. They pointed out that in addition to the different doses required by pediatric patients, they may also have age-dependent developmental differences in how they metabolize sedatives and analgesics. In addition, there are anatomical differences in the airway that providers will need to understand.

The use of sedation in dentistry may also reduce the number of emergent dental problems that can be a result of neglecting dental care due to fears associated with the perceived pain of dental procedures. Presenters also shared that it can be useful in interventional radiology for procedures that require patients to remain still for long periods of time.