What does this research mean for the field?

Procedural sedation and analgesia (PSA) is available in 56.8% of emergency departments without emergency physicians in the Netherlands, with significant gaps in pediatric PSA provision. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 1, 2026

Availability and quality of procedural sedation and analgesia in emergency departments without emergency physicians:A national survey in the Netherlands

Key Points

This research aims to assess the availability and quality of procedural sedation and analgesia in emergency departments without emergency physicians in the Netherlands.
Conducted an exploratory cross-sectional study across 13 emergency departments.
Gathered data using a standardized questionnaire from ED nurses and physicians.
Achieved a 34.3% response rate from participants.
56.8% of respondents reported providing adult procedural sedation and analgesia.
20.3% of respondents provided pediatric procedural sedation and analgesia.
Main reasons for not offering PSA include lack of trained staff and insufficient training.
Providers expressed greater confidence in their adult PSA competencies compared to pediatric patients.

Abstract

BACKGROUND: Emergency physicians have been successful in implementing procedural sedation and analgesia (PSA) to treat emergency department (ED) patients who need to undergo painful procedures. However, 25% of the EDs in the Netherlands are not staffed by emergency physicians. The aim of this study was to investigate PSA availability and quality in EDs without emergency physicians. METHODS: We performed an exploratory cross-sectional study amongst ED nurses and physicians in all 13 EDs without emergency physicians in the Netherlands. Data were gathered using a standardized questionnaire. RESULTS: The response rate was 34.3% (148/432). Of the respondents, 84/148 (56.8%) provided adult PSA and 30/148 (20.3%) provided paediatric PSA. Main reasons for not providing PSA were insufficient numbers of trained staff to support PSA in the ED and insufficient training and exposure. The providers agreed significantly stronger when reflecting their PSA competencies in adults compared to paediatric patients. CONCLUSION: The key to improve pain management in the ED-setting may lay in investing in continuous training of ED health care professionals and/or acquiring professionals who are both ualified in PSA and available in the ED

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Cite This Study

Kuypers et al. (Wed,) studied this question.

synapsesocial.com/papers/69a3d6eaec16d51705d2d991 https://doi.org/https://doi.org/10.5847/wjem.j.1920

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