Procedural sedation analgesia in prehospital settings: The state of the art

The utilization of analgosedation procedures is progressively becoming more prevalent in conducting a diverse spectrum of procedures necessitated by the patient’s clinical condition. Such procedures may be undertaken by physicians, anaesthesia nurses, and paramedics alike. Due to the broad competencies of employees of the state emergency medical system, it is possible to carry out analgosedation in the prehospital setting. However, performing analgosedation in that situation presents considerable challenges owing to limited familiarity with the patient’s history, available equipment, and environmental conditions at the scene. Hence, prehospital healthcare providers must possess comprehensive knowledge of the procedural capabilities and technical skills associated with analgosedation to mitigate the risk of adverse events. Proficiently executed analgosedation, based on the conscious use of available equipment, medications and the procedure’s capabilities holds significant importance in achieving the desired procedural outcomes and positively impacting the patient’s clinical status. As no formal guidelines in analgosedation for prehospital providers have been developed the authors aimed to summarize current knowledge and skills required to minimize the risk for patients. The authors also aimed to highlight the necessity of responsible and thoughtful training to perform analgosedation in the prehospital setting to develop desirable correct habits and increase situational awareness.