Procedural sedation by advanced care paramedics for emergency gastrointestinal endoscopy

Abstract

CLINICIAN'S CAPSULE What is known about the topic? Advanced care paramedics (ACPs) in our emergency department (ED) successfully perform procedural sedation and analgesia (PSA) for several procedures, including orthopedic manipulations. What did this study ask? How does the novel practice of ACP-led ED PSA for upper gastrointestinal (UGI) endoscopy compare to that for orthopedic procedures? What did this study find? Adverse events occurred more frequently during UGI endoscopy sedations than orthopedic sedations (41.0% v. 17.5%), with hypotension occurring most often. Why does this study matter to clinicians? ACP-led ED PSA may be expanded to include UGI endoscopy when the risk of hemodynamic compromise is taken into account.