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We have had the same pushback and unfortunately Anesthesia In our
institution has prevailed. I have worked at University Medical Center in
Las Vegas and Saint Rose Hospital and one MD sedation with nurse monitoring
was the standard. I of course agree with the one MD course, we never had an
issue.
On Tue, Nov 18, 2014 at 4:09 PM Bernard Dannenberg <[log in to unmask]>
wrote:

> 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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