Administration of Sedative and Analgesic Medications by Respiratory Care Practitioners

The American Association for Respiratory Care (AARC) recognizes the fact that Respiratory Therapists are called upon to assist physicians with the administration of sedative and analgesic medications during diagnostic and therapeutic procedures.

"Sedation" and "analgesia" describe a physical state in which the patient is able to tolerate unpleasant procedures, while maintaining adequate cardiorespiratory function, and the ability to respond purposefully to verbal commands and tactile stimulation. The AARC believes that Respiratory Therapists working under direct medical supervision can assist physicians during diagnostic and therapeutic procedures, and help to minimize risks by administering prescribed medications and closely monitoring the patient.

The AARC recognizes and acknowledges the following:

• The American Society of Anesthesiologists (ASA) has published the document "Practice Guidelines for Sedation and Analgesia by Non-anesthesiologists."
• The purpose of the ASA document is to allow clinicians to provide their patients with the benefits of sedation and analgesia while minimizing associated risks.
• The ASA Guidelines should be followed by all Respiratory Therapists called upon to provide this service.
• The clinicians and their facilities have the ultimate responsibility for selecting patients, procedures, medications, and equipment.
• Respiratory care education programs approved by the Commission on the Accreditation of Allied Health Education Programs/Committee on Accreditation for Respiratory Care (or their successor organizations) provide appropriate pharmacologic and technologic training to enable Respiratory Therapists who have successfully completed a formal training and competency assessment program working under medical direction and under direct orders from a physician to safely administer sedatives and analgesics (by whatever routes and in whatever doses of medication selected by the physician) by following the ASA Guidelines.

Following successful completion of a formal education and competency assessment program the Respiratory Therapists must:

• Be knowledgeable about the techniques, medications, side effects, monitoring devices, response or untoward effects of medications, and documentation for any specific procedure.
• Meet qualifications to be certified as competent, in accordance with her/his facility's and Respiratory Care Service's policy, to administer sedatives and analgesics under medical supervision and the direct orders of the physician performing the procedure, or the anesthesiologist in attendance.

The AARC affirms that Respiratory Therapists who have successfully completed a formal education and competency assessment program on sedation and analgesia based on the ASA's Guidelines, and who have been certified as competent by the appropriate medical director and department head or governing body should be permitted to provide the service in accordance with ASA's Guidelines, facility policies, procedures, protocols, and service operations, as well as with JCAHO and state requirements and policies.

Reference: "Practice Guidelines for Sedation and Analgesia by Non-anesthesiologists," Anesthesiology, 1996; 84:459-471

Effective 12/97
Revised 3/00