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Enteral vs Parenteral Modalities

In considering whether to offer an enteral sedation course, the ASAASD carefully evaluated the ADA guidelines and educational requirements.  Concerns regarding enteral sedation training include the following:

  1. titration is the technique that is most likely to produce satisfactory outcomes while offering patients maximal protection against oversedation;
  2. the oral route does not permit titration and does not eliminate the possibility of serious oversedation, the management of which may require a high level of preparedness and skill;
  3. emergency protocols including ACLS-level pharmacologic interventions rely to a significant degree on the ability of the clinician to obtain intravenous access;
  4. the skill required to obtain intravenous access is far more predictably maintained when this technique is used on a regular basis, and the clinician with limited training and little ongoing experience is less likely to apply such techniques successfully, particularly under duress.