Pergsmon The Journal of Emergency Medicine, Vol 13, No 2, 279-281, 1995 pp Copyright 0 1995Elsevier ScienceLtd Printed in the USA. All rights reserved 0736-4679/95$9.50 + .oo CAEP /Uews WORKING GROUP ON ANAESTHESIA IN THE EMERGENCY DEPARTMENT Alan J. Drummond, MD, CM, CCFP(EM) Several years have passed since CAEP began to pro- mote an improved standard of care with regards to the provision of anaesthetic services in the nation’s emergency departments. The Walls-Murphy “road show” fostered an enhanced awareness of the use of rapid sequence intubation (RSI) in airway manage- ment and procedural sedation. Coupled with the de- velopment of CAEP guidelines on pain management and sedation, these initiatives have altered the nature of practice in a fundamental and positive fashion but have occasionally brought the emergency physician in conflict with the anaesthetist over the issue of “turf.” To assist in the introduction and development of safe anaesthetic practice in the nation’s Emergency Departments, CAEP formed a working group to ex- amine, clarify, and assist in the resolution of any issues of contention. Furthermore, it is the intention of the group to establish guidelines for the safe and appropriate use of anaesthetic agents and products in Emergency Medicine. This group had its initial meeting in June at the Kelowna AGM and was chaired by Michael Murphy of Halifax. Members of the group included Drs. Grant Innes, Isser Dubinsky, and Jim Ducharme (Emergency Medicine); Dr. Cheri Nijssen-Jordan (Paediatric Emergency Medicine); Drs. Gordon Jackson and Alan Drummond (General Practice/Anaesthesia); and Dr. Bob East ( Anaesthesiology). It became quite clear that in most Canadian hospi- tals, anaesthetic coverage of the Emergency Depart- ment is variable and unreliable. The emergency phy- sician, therefore, must be prepared to provide “anaesthetic services” (airway management, proce- dural sedation), when this intervention is mandated, by the not so infrequent clinical scenario of life and limb threatening emergencies. This having been stated, the following areas of concern were highlighted for further study: 1. There needs to be expanded educational programs and training opportunities to allow the emergency physician to appropriately select and safely use an- algesic/anaesthetic agents in the following clinical scenarios. a) pain management b) procedural sedation c) patient control d) airway management 2. There must be greater awarenessand institutional commitment to: a) the absolute requirement for the provision of appropriate facilities, staff, monitors, and equipment prior to the introduction of anaes- thetic agents in emergency department prac- tice; b) the development of thoughtful, universally ap- plicable policies and procedures, developed in consultation with departments of anaesthesia, for the safe use of anaesthetic agents in Emer- gency Medicine; and c) the development and institution of Quality As- surance programs for: i) the introduction of new anaesthetic agents into Emergency Departments, and ii) procedures - specific credentialling CAI%PNews is coordinated by Alan Drummond, MD, of the Canadian Association of Emergency Physicians (CAEP) 279