Procedural Sedation & Analgesia

Strategic Leader: Gary Andolfatto


Safe, effective, timely, efficient, equitable, and patient centered evidence-based care to patients requiring emergency department procedural sedation and analgesia in BC.

Long Term Goals

To implement best practices for the provision of emergency department procedural sedation and analgesia that improve patient comfort, safety and emergency department flow and efficiency.

Short Term Goals

To design, develop and refine techniques, medication regimens, and monitoring strategies to improve the provision of emergency department procedural sedation and analgesia.

Key Partners and Stakeholders

  • The Lions Gate Hospital Foundation
  • The Vancouver Coastal Health Research Institute
  • The North Shore Health Research Foundation
  • Harvard Children’s Hospital
  • Massachusetts Institute of Technology and,
  • several US and European sites.

Work to Date

We have completed several studies on the use of a novel combination of medications for emergency department sedation in both adults and children that may result in improved patient care and more efficient use of emergency resources. Work to date includes clinical comparison trials looking at effects on breathing, adverse effects and patient comfort, as well as physical and chemical compatibility studies.

There has been the formation of an international collaborative project with Harvard Children’s Hospital, Massachusetts Institute of Technology and several other centers in the US and Europe designed to investigate novel patient monitoring strategies with regards to vital signs. This is meant to significantly improve patient safety through the development of monitoring capabilities designed to predict adverse events before they occur. Through a year-long collaborative effort involving the engagement of relevant stakeholders a comprehensive Clinical Practice Guideline describing the suggested standards (“best practice”) for safe and effective emergency department procedural sedation and analgesia for the Vancouver Coastal Health Region was produced and is currently being reviewed and updated.

We have recently accepted an invitation to be a founding member of the International Committee for the Advancement of Procedural Sedation in March 2015. This mission of this committee is to provide an independent, international, multidisciplinary forum to facilitate open dialogue and consensus generation between experts in the area of sedation, and to promote optimal, evidence-based, safe and effective practices for worldwide procedural sedation and analgesia in patients of all ages.

Currently, projects designed to improve the delivery of analgesia to ED patients using novel intranasal delivery systems and clinical algorithms are currently underway. Future comparison trials of analgesic agents are in planning stages.