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A straw poll to all members

We have written a new policy for deep sedation in our Pediatric Emergency Department.

The following sentence has raised significant resistance by our anesthesia department:

> The physician administering deep sedation may also perform the procedure if a qualified ED registered nurse (RN) is present to continuously monitor the patient.

Their argument is that not one academic institution they contacted would permit this.
Naturally I am suspicious. CMS guidelines appear to allow that one provider can administer the sedation if a qualified nurse is present to monitor the patient.
The California Department of Public Health has issued the following clarification in July 2013
http://www.cdph.ca.gov/certlic/facilities/Documents/LNC-AFL-13-17.pdf

Can you respond to me directly what your institution is allowing you to do. 

A. 2 physicians need to be present: One performs the sedation, the other performs the procedure

B. 1 physician can administer the sedation and perform the procedure if a qualified RN is monitoring the patient

I will tabulate the answers and distribute them back to the group.

Thank you for your assistance 

Bernard Dannenberg, MD, FAAP, FACEP
Clinical Associate Professor
Davies Family Director, Pediatric Emergency Medicine
Division of Emergency Medicine
Department of Surgery
Stanford University School of Medicine
Lucile Packard Children’s Hospital
300 Pasteur Drive
Alway Building M-121
Stanford, CA  94305
(650) 721 2450   FAX:  (650) 723-0121
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