Ya know, I do some sedation on a regular basis, for dislocation or fracture reductions, cardioversions, intubations, etc.etc. One of my favorites besides propofol, is etomidate and versed. However, for a long time, we have been cautioned against using etomidate in any patient with suspected infection, such as elderly patient with respiratory distress that could be secondary to pneumonia or sepsis. This warning has been based on an older study that showed increased mortality in patients with sepsis who had also recieved etomidate, this is thought to be due cortisol production suppression and a blunting of the ACTH response. Etomidate does cause both of these effects, however, this is a transient effect. Per Ron Walls, MD, "there has been no credible study that goes against using etomidate in septic shock and...the greatest service we can do to our patients is to conduct the large, high quality trials needed to base our clinical practice on truly robust evidence."
Source: Ron Walls, MD; Annals of Emergency Medicine 2008;52(1):13-14
For myself, until this is sorted out, I will continue to use propofol in adult patients who are considerd possibly septic, and ketamine in children.
FWIW, before anyone asks, YES, at our instituion, the PA's can perform the sedation, as long as the attending is aware of what you are doing. Some attendings like to be present, others only want to know if there is a problem.