Adult Procedural Sedation Flashcards
Adult Procedural Sedation - Sedation may be required for
Cardioversion
Fracture realignment
Pacing
Adult Procedural Sedation - Required monitoring equipment
4-lead ECG
ETCO2
SpO2
Adult Procedural Sedation - medications?
Midazolam 0.05 mg/kg to single max 2.5 mg
Fentanyl 1 mcg/kg to single max of 100 mcg
And/or
Ketamine 0.5 mg/kg SIVP q 5 max of 1 mg/kg
Adult Procedural Sedation - Vitals frequency during sedation
q 5 min while sedated
q 15 post sedation
Adult Procedural Sedation - Equipment to have prepared and available prior to administering sedation?
Basic airway equipment
Naloxone if opiates used
Adult Procedural Sedation - Nitrous oxide indications
Procedural sedation for fracture realignment
Adult Procedural Sedation - Nitrous oxide dose
Self administered prn
Adult Procedural Sedation - Nitrous oxide EMS contraindications
Inability to follow verbal instructions Intoxication with alcohol or drugs Head injury with altered mental status Thoracic injury Abdominal pain
Adult Procedural Sedation - Nitrous oxide precautions
Invert canister three times prior to administration
Adult Procedural Sedation - Fentanyl dose
BP > 100 - 1 mcg/kg to max of 100 mcg
no repeat dose
Adult Procedural Sedation - Fentanyl EMS contraindications
Hypersensitivity
Systolic BP < 100 mmHg
MAOI therapy within last 14 days
Adult Procedural Sedation - Ketamine indications
Long lasting procedural sedation for cardioversion and fracture realignment
Adult Procedural Sedation - Ketamine dose
BP < 100 0.5 mg/kg SIVP max of 1 mg/kg
Consider half dose if patient 65 years or older
Adult Procedural Sedation - Ketamine EMS contraindications
Hypersensitivity
Conditions where a significant elevation of blood pressure is hazardous
Adult Procedural Sedation - Midazolam dose
midazolam 0.05 mg/kg SIVP to a single max dose of 2.5 mg
Consider half dose if patient 65 years or older
No repeat dose
