Assessment for Intravenous Sedation

Question 1

Whats GDC definition of sedation?

Answer 1

technique in which use of drug(s) produces state of depression of the CNS allowing tx to be carried out.

BUT pt must be in a state to maintain communication and respond to commands during the sedation

Question 2

If you wish to practice IV sedation after graduating, is extra training required?

Answer 2

yes, further training is needed

Question 3

what is a sedation assessment?

Answer 3

a full assessment that confirms the tx required, and whether sedation is actually needed + the preferred technique to be used

Question 4

what is midazolam?

Answer 4

a benzodiazepine used for IV sedation

Question 5

what can cause increased in the sedative effect of midazolam?

Answer 5

alcohol
opiods
erythromycin (antibiotic)
anti-depressants/histamines/psychotics
Recreational drugs

Question 6

what does ASA classification mean and what is it used?

Answer 6

the american society of anaesthesiologists

used to assess pt overall health status before surgery or a medical procedure that involves anesthesia

Question 7

what are the grades and meanings of each ASA classification?

Answer 7

Grade 1 - normal healthy pt, non smoker, minimal alcohol

Grade 2 - Mild systemic disease

Grade 3 - severe systemic disease; limits activity but not incapacitating

Grade 4 - Severe systemic disease; constant threat to life

Grade 5 - Moribund; not expected to live longer 24hrs

Grade 6 - Pt is brain dead for organ donation

Question 8

what ASA classification grades can be treated in primary care and secondary care?

Answer 8

Grade 1 & 2 - may be tx in primary care

Grade 3 - should be tx in secondary care (CASE BY CASE DEPENDING)

Grade 4 - MUST be tx in secondary care

Question 9

what is the difference between primary and secondary care?

Answer 9

primary - first point of contact people like dentists, gp, pharmacists etc

secondary - stuff like consultants, surgeons, who you get a referral to see for further tx/complexer cases

Question 10

why is respiratory disease important to know about if the patient has it?

Answer 10

almost all sedative agents cause RESPIRATORY DEPRESSION so it can help plan/watchout for possible complications

(get to know how controlled their asthma is etc)

Question 11

what are a difficult category of patients to tx with sedation?

Answer 11

Neurosis & Psychosis patients

Question 12

what is meant by pharmacodynamic interactions?

Answer 12

interactions between drugs which have similar or antagonistic (opposite) pharmacological or systemic effects

Question 13

what is the BMI cutoff for sedation?

Answer 13

BMI must be under 35