Service reviews by the Royal College of Anaesthetists’ Anaesthesia Clinical Services Accreditation (ASCA) programme suggest that the recommendations in the 2013 Academy of Medical Royal Colleges (AoMRC) guidance on safe sedation practice have not been fully enacted upon by.
In response to this the Academy of Medical Royal Colleges published, ‘Safe sedation practice for healthcare procedures. An update’1 in February 2021. This update does not replace the 2013 publication, but serves to re-emphasise and revise its recommendations in line with other authoritative guidance. It summarises the 2013 recommendations to provide regulators with a set of standards against which to inspect facilities providing sedation and to ensure that safety standards are being met.
The recommendations in the 2021 update are summarised as follows:
-
Equity across all UK healthcare sectors
-
Establishment of Sedation Lead in all facilities where sedation is provided. Hospitals and clinics where sedation is provided should have a Sedation Group (or committee)
-
Training and education in sedation practice – practitioners providing sedation to patients for therapeutic and diagnostic procedures in healthcare facilities should undergo documented training in the knowledge, skills and competencies necessary for safe sedation
-
Routine audit of sedation practice
-
Use of incident reporting system
-
Patient preparation (including; pre-assessment, consent and fasting)
-
Oxygen administration and patient monitoring (for conscious sedation this includes; supplemental oxygen, pulse oximetry, capnography, ECG and automated non-invasive blood pressure)
-
Procedural teams (to include a trained assistant to monitor the patient , with no other role, responsibility or tasks whenever conscious sedation is used)