complications of conscious sedation Flashcards
1
Q
what is flumazenil
A
- reversal drug for sedation
2
Q
what are complications if cannulation
A
- venospasm
- extravascular injection
- intraarterial injection
- haematoma
- fainting
3
Q
what is venospasm
A
- disappearing vein syndrome, vein collapses as you go in with cannula
- can be accompanied by burning feeling
- associate with poorly visible veins
4
Q
management fo venospams
A
- worse with repeated attempts
- go fast, slow makes it worse
-weaer gloves before, or use hot water to dilate
5
Q
what is extravascular injection
A
- drug placed in interstitial space
- pain, swelling
- delayed absorption. problem = could pversedate pt
6
Q
management of extravascular injection
A
- good techniques, test with saline
- remove cannula, apply pressure, reassure
7
Q
what is intraarterial injection
A
- pain on venipuncture as artery walls thicker
- red blod in cannula
- difficult to prevent leaks
- pain radiating distally from cannulation site
- loss of colour or warmth to limb, weakening pulse
8
Q
management of intra-arterial injection
A
- palpate first to check no pulse
- monitor for pulse loss
- leave cannula in for 5 mins
- if no problems then remove
- if symptomatic, leave nd refer to hospital
9
Q
what is haematoma
A
- extravasation of blood into soft tissues = big bruise
- due to damage to vein walls from poor technique or when removing cannula failed to apply pressure
- care with elderly pts
10
Q
Management of haematoma
A
- good technique, pressure post-op
- initial ice pack, moist heat 20 mins in, consider hearing containing gel if severe
11
Q
how to prevent fainting from cannulation
A
- anxiety related usually, try get pt to relax
- make sure pt has eaten
- can give IS to relax them enough
- topical skin analgesia can help
12
Q
what are the complications of drug administration
A
- hyper-responders
- hypo-responders
- paradoxical reactions
- oversedation
- allergic reactions
- sexual fantasy
13
Q
what are hyper-responders
A
- deep sedation with minimal dose
- care with titration needed = only 1mg increments after initial 5mg dose
- more common in elderly
14
Q
what are hypo-responders
A
- little effect with large dose
- check cannula is in the vein
- some pts lie about feeling it
- can be due to a drug tolerance pt never told you about
15
Q
what is the highest threshold for drug
A
- shouldn’t go over 10mg, BNF actually says 7.5mg