The NSW Safe Sedation Project
To the Editor: About 300 000 episodes of procedural sedation occur annually in New South Wales public hospitals. Much of this sedation is supervised by non-anaesthetists.
Complications of procedural sedation are usually related to airway obstruction or depressed ventilation and can be life-threatening. Therefore, clinicians who administer sedation and care for sedated patients should have adequate knowledge and skills to assess, manage and provide rescue to these patients.
The Australian and New Zealand College of Anaesthetists has addressed the issue of procedural sedation since 1984 via policy statement PS09.1 Many specialist groups are cosignatories to PS09; however, its implementation has been incomplete.
Anaesthetists in NSW have long been aware of adverse outcomes from procedural sedation, and of reports from nursing staff who care for sedated patients and who feel poorly trained and unsupported for the tasks required.
The NSW Safe Sedation Project was established to support the safe provision of non-anaesthetist-administered intravenous procedural sedation. The project included development of minimum standards of care, a survey of NSW hospitals to confirm feasibility of the standards and raise awareness of PS09, and development of a toolkit including an audit tool.2