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To evaluate the safety of a one-physician/one-nurse model for procedural sedation for orthopedic reductions, researchers reviewed records for 435 patients who underwent reduction of fractured forearms or dislocated shoulders, hips, or elbows at three community emergency departments during an 18-month period. Procedures were performed by attending physicians while nurses administered medications; all nurses were trained and certified in procedural sedation.
Sedative agents used included propofol, etomidate, ketamine, methohexital, and midazolam in 303, 67, 57, 17, and 13 cases, respectively (some patients required a second reduction). Adverse events (predefined as events requiring airway interventions, reversal agents, anti-dysrhythmic agents…