A coalition of nursing, physician, and other health care associations has drafted a consensus statement to support appropriately trained emergency department (ED) nurses who administer procedural sedation. The Emergency Nurses Association (ENA) defines procedural sedation as "a technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows the patients to tolerate an unpleasant procedure while maintaining cardiorespiratory function."

The administration of procedural sedation by specially trained RNs is controversial and has been vigorously opposed by some physician and nurse-anesthetist groups. For example, the Pennsylvania Society of Anesthesiologists and several other groups have asked state nursing regulators to restrict ED nurses from administering procedural sedation unless an anesthesiologist or CRNA is immediately available.

Last summer the ENA led a summit to discuss the conditions under which procedural sedation is properly performed in the ED. The resulting Procedural Sedation Consensus Statement has been endorsed by the ENA, the American Association of Critical-Care Nurses, the American College of Emergency Physicians, the American Radiological Nurses Association, and other groups.

"Allowing properly trained and supervised emergency nurses to administer procedural sedation is safe and in the best interests of the patient," says Donna Mason, RN, CEN, MS, immediate past president of the ENA. Without this option, she adds, many patients will wait longer for treatment and experience more pain, outcomes not consistent with high-quality care.

The consensus statement is available on ENA's Web site: http://www.ena.org/about/position.