Procedural sedation in Emergency Medicine

Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. 

Indications for procedural sedation, stratified by urgency

Emergent (e.g. cardioversion for life-threatening dysrhythmia, reduction of markedly angulated fracture/dislocation with soft tissue or vascular compromise, intractable pain or suffering).

Urgent (e.g. care of dirty wounds and lacerations, animal and human bites, fracture reduction, shoulder reduction, hip reduction, arthrocentesis, neuroimaging for trauma).

Semi-urgent (e.g. care of clean wounds and lacerations, foreign body removal, sexual assault examination).

The pharmacological agents typically used for procedural sedation