Conscious sedation is a means to allow a child to tolerate an otherwise painful procedure with minimum risk and maximum tolerance. Various definitions of conscious sedation, more appropriately termed sedation with or without analgesia, exist iii the literature (the term conscious sedation will be used for ease of reference I. In the simplest terms the patient is sedated to the point where response to, and awareness of, pain are reduced. However, the patient can maintain his own airway and he easily aroused to consciousness. The term deep sedation is applied when the patient may not be able to independently maintain airway control and cannot be easily aroused to consciousness but can respond with purposeful movement when stimulated. This article reviews the various published guidelines dealing with conscious sedation for procedures performed without au anesthesiologist and outside of the operating room, including indications, patient preparation, staffing and documentation guidelines and billing and coding issue. Guidelines published by the American Academy of Pediatrics and the American Society of Anesthesiologist's s provide an important basis for the discussion.