Equipment

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Access to the correct equipment is essential to safe procedural sedation.

Intravenous, patient monitoring and emergency equipment are required for every episode of procedural sedation.

Intravenous equipment:

  • Intravenous access

Monitoring equipment:

  • Pulse oximeter
  • Non-invasive blood pressure
  • Capnography
  • Electrocardiogram (ECG)

Emergency and other equipment:

  • Cannulation equipment
  • Oxygen
  • Oropharyngeal suction
  • Emergency equipment, including a defibrillator and drugs used for cardiac arrest
  • A means to inflate the lungs with 100% oxygen, such as a self-inflating bag and waters circuit (Mapleson C) or T-piece and suitable sizes of face mask
  • Equipment to assist in airway management, e.g. oropharyngeal and nasopharyngeal airways, laryngeal mask airways, a range of laryngoscopes and endotracheal tubes

When opioids or benzodiazepines are the principal sedatives, their reversal agents should be readily available.1–3

Atropine or glycopyrrolate should be available to treat bradycardias and ephedrine or metaraminol (in suitable dilution) to treat hypotension if severe (SBP < 80 mmHg), along with cessation of sedative drug administration.

Resources

PG09(G) Guideline on procedural sedation 2023
Further guidance on the equipment required for procedural sedation.
Source: Australian and New Zealand College of Anaesthetists

References

  1. Benzoni T, Cascella M. Procedural sedation. Treasure Island, Florida: StatPearls Publishing; Jan 2024.
  2. Green SM, Roback MG, Krauss BS, et al. Unscheduled Procedural Sedation: A Multidisciplinary Consensus Practice Guideline. Ann Emerg Med. 2019;73(5):e51-e65. DOI: 10.1016/j.annemergmed.2019.02.022
  3. Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. Anesthesiology. 2018;128(3):437-79. DOI: 10.1097/aln.0000000000002043
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