Propofol and Other Sedating Agents Can Be Safely Used by Emergency Physicians without an Anesthesiologist Present

Clinical Policy Statement
It is the position of the American Academy of Emergency Medicine that emergency physicians must be permitted by hospital bylaws and credentialing procedures to utilize propofol (and other sedating agents) for the induction of procedural sedation, without an anesthesiologist present.

A large body of research supports the assertion that propofol and other sedating agents, such as etomidate and ketamine, can be safely used by emergency physicians (EPs) without an anesthesiologist present. Propofol is particularly useful for inducing sedation and amnesia for patients undergoing brief painful procedures in emergency departments (EDs). Propofol has advantages over older sedative/amnestic agents such as benzodiazepines, which have longer half lives and potentially adverse risk/benefit ratios. Medical decisions must be made on a patient-by-patient basis, and benzodiazepines may be appropriate for some patients. However, emergency physicians’ access to propofol must not be constrained by needless administrative or regulatory barriers.

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References and Literature Grading (PDF)