Out of theatre sedation – how I do it safely

Abstract

Over the last few years I have had the pleasure and privilege of providing procedural sedation and analgesia (PSA) in a number of locations remote to theatre at Chris Hani Baragwanath Academic Hospital (CHBAH). Of note has been providing PSA for transesophageal echocardiography (TEE) at the cardiology department of CHBAH. This has been a steep learning curve as the high-risk patient profile adds to the stress of working in what is already a daunting environment and ‘anaesthetic’. Through this experience, I have learnt much about the safe practice of PSA outside of the operating theatre environment. This article will summarise the lessons learnt using my experiences to emphasise the prerequisites for the safe practice of PSA in remote locations. I will start with a brief discussion of basic concepts and then move on to how we have adhered to local and international guidelines to ensure safety in our environment.