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Conscious sedation

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For all of those practicing in CA, do any of you do independent procedures using conscious sedation (verses/fentanyl). At One hospital I was able to, now I’m at another hospital and I’m not allowed and was quoted the PAB book of regulations that state procedures can be done with local anesthesia only, any other procedures with other types of anesthesia SP must be present. Anyone have any thoughts on why the other hospital allowed it?

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I do conscious sedation multiple times a week for RSI, chest tubes, and other various invasive procedures. I just had to keep a log and have an attg sign off on 4 occurrences and then became privileged. The alternative if you don’t do enough is to take a 6hr long course and write for conscious sedation for a day in the outpatient clinic with an anesthesiologist. None of my conscious sedation procedures require an attending to be present. I don’t think there’s any hard and fast rule that a SP needs to be present, it’s based on the hospital system.


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you do conscious sedation for chest tubes?


I do. It’s extremely painful. Most of my patients are intubated. Once the tube is placed we often keep them on sustained drips on fentanyl dilaudid or morphine and can also use precedex, versed, or Ativan on top of the opioids to keep them from getting too agitated and limit movement once the tube is in
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On 3/21/2019 at 1:13 AM, NYCPAC said:

I do conscious sedation multiple times a week for RSI, chest tubes, and other various invasive procedures. I just had to keep a log and have an attg sign off on 4 occurrences and then became privileged. The alternative if you don’t do enough is to take a 6hr long course and write for conscious sedation for a day in the outpatient clinic with an anesthesiologist. None of my conscious sedation procedures require an attending to be present. I don’t think there’s any hard and fast rule that a SP needs to be present, it’s based on the hospital system.


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If you don't mind me asking, what do you specialize in? 

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Are moderate sedation privileges hospital dependent? I ask because I am a IR PA and my hospital does not allow allied health practitioners moderate sedation privileges. 

Thanks in advance. Any help appreciated

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It's both facility and state dependent.  In Ohio, by state law I can't do procedural sedation.  In Indiana, by state law I can, but the doc has to be in the ED (I do EM).  However, the Indiana hospital chain I work in does not permit it.

However, as a paramedic in Ohio I can RSI, just not as a PA.

Edited by ohiovolffemtp

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