Lund, Sweden

Procedural Sedation & Analgesia

Clarity in Emergency Medicine

Some of the patients that present to the Emergency Department require painful procedures, of which a few need to be performed urgently. In order to receive timely care, these patients benefit from being managed by local residents and specialists in Emergency Medicine who can safely perform procedural sedation and analgesia (PSA).


The medical literature is replete with publications detailing the safety of emergency physician-driven PSA. The Emergency Departments of Lund and Malmö introduced a protocol and certification process for emergency physician-driven propofol sedation prior to electrical cardioversion of hemodynamically stable patients with atrial fibrillation. An account of the outcome of the first 321 consecutive patients who underwent emergency-physician propofol-sedation at Lund’s Emergency Department was published in the Swedish Medical Journal [1].

Monitoring of the safety of emergency physician-driven PSA is ongoing. In addition, the indications for emergency physician-driven PSA and the medications used are being expanded.

[1] Dryver E, Larsson D, Pahlm U. Swedish emergency physicians can safely sedate patients with propofol prior to cardioversion. Läkartidningen 2019;116.