Intravenous sedation in accident and emergency departments: a nationwide survey.

Anonymous questionnaires regarding the practice of intravenous sedation were sent to all accident and emergency departments in England and Wales. The response rate was 63%. Intravenous sedation was used by 94% of the departments who replied. In 19% of these departments it was administered only by middle grade or senior grade clinicians, while in the remaining 81% sedation was also administered by junior grade clinicians. Diazepam, midazolam and opioids were the most commonly used agents. The use of monitoring was variable. In 16% of the units no monitoring was used routinely. ECG monitoring was carried out by 48% of the departments, non-invasive blood pressure monitoring by 67% and pulse oximetry by 65%. Our findings indicate there is a need for guidelines regarding patient selection, the choice of drugs and the monitoring of patients.