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Procedural sedation: what would the patient like?
  1. Gavin Lloyd1,
  2. Alasdair Gray2
  1. 1Emergency Department, Royal Devon & Exeter Hosptial Wonford, Exeter, UK
  2. 2Emergency Department, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Gavin Lloyd L162, Emergency Department, Royal Devon & Exeter Hospital Wonford, Barrack Road, Exeter EX2 5DW, UK; gavin.lloyd{at}nhs.net

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Imagine breaking your ankle. Worse still having a fracture/dislocation of your ankle that you recognise needs manipulation. What are your thoughts preprocedure? How confident are you of a painless (and hopefully successful) reduction? Might we assume that deep down, you dread an uncomfortable experience and its recall? In similar circumstances what are patients’ genuine experiences?

Analysis of the emergency medicine literature reveals widely varying recall rates: 7%,1 12%–13%,2 12%–16%,3 65%4 and 90%.5 More importantly, patients reporting painful recall of the procedure on return to baseline mental status has been recorded as 2%–6%,2 10%–14%3 and 30%.4 In a randomised controlled …

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