The clinical governance framework for ED sedation should include adequate supervision and training of staff, the use of clinical guidelines and facilities required for safe practice.

The sedation record should be used to facilitate an ongoing audit of the process and outcome of sedation. This should include the incidence of adverse events such as cardiorespiratory depression, over sedation, use of reversal agents, unexpected admission or delayed discharge.

The implementation of these should reduce the incidence of adverse events and improve the quality of procedural sedation, making it safer and a more satisfactory experience for patients and practitioners.