Levels of Awareness of Procedural Sedation and Analgesia among Non-anaesthesiologists at an Academic Hospital in Johannesburg, South Africa

Background: Procedural sedation and analgesia (PSA) is performed by a group of non-anaesthesiologists in numerous hospital settings. Currently, there is no literature describing sedation practices among non-anaesthesiologists in South Africa despite its wide use. Aim: To describe the profile of non-anaesthesiologist PSA providers at Chris Hani Baragwanath Academic Hospital (CHBAH), their awareness of the South African Society of Anaesthesiologists (SASA) Sedation Guidelines 2010 and their level of comfort when performing PSA. Methods: A questionnaire was used to assess the demographic profile of non-anaesthesiologists providing sedation at an academic hospital in Johannesburg, their awareness of the SASA Sedation Guidelines 2010 and their level of comfort when performing sedation were assessed. Results: A total of 159 questionnaires were received from the departments of general surgery and trauma, radiology, emergency medicine, orthopaedics and internal medicine. The overall levels of awareness of sedation guidelines among non-anaesthesiologists are poor. The mean score (standard deviation) for correctly answered questions was 19.55 (4.75) of 31 questions. Junior doctors scored higher than consultants ( p = 0.008) but were more likely to feel uncomfortable administering sedation ( p = 0.031). A significant relationship between pharmacology knowledge and levels of comfort was also revealed ( p = 0.014). Levels of comfort were higher among consultants despite achieving lower knowledge scores. Conclusion: The levels of awareness of PSA among non-anaesthesiologists are lacking. While guideline knowledge was substantially better than pharmacology knowledge, an opportunity to address these deficiencies exists in the form of PSA specific training.