Conscious Sedation

Question 1

what are the SDCEP recommendations regarding staffing for sedation

Answer 1

need 2 sedation trained people in the room
clinical team can recognise complications
ensure no member of staff is alone with a sedated patient

Question 2

what should be assessed at the sedation assessment appointment

Answer 2

history
anxiety and sedation history
determine ASA status
oral exam
explore all anxiety management techniques
make sure decision is the most suitable and is justified
document justifications for conscious sedation
BP, oxygen sats, HR

Question 3

what is the consent process for sedation

Answer 3

obtain valid consent prior to administration of sedative drugs
consent at separate appointment and then again at sedation
record in notes

Question 4

how should you provide pre and post sedation instructions

Answer 4

verbally and in writing for patients, parents and escorts that are specific to patients needs
detail escort responsibilities
record instructions given in patients notes

Question 5

what is used for inhalation sedation

Answer 5

titrated dose of nitrous oxide with oxygen

Question 6

what is used for intravenous sedation

Answer 6

titrated dose of midazolam

Question 7

if a patient is given oral sedation what should you try to do as soon as possible

Answer 7

cannulate the patient

Question 8

what are the recommendations for monitoring a patient during sedation

Answer 8

monitor from pre-operative stage until discharge criteria is met
record monitoring

Question 9

what is the preferred sedation technique for children

Answer 9

IHS

Question 10

what do you need to make sure of during the recovery period after sedation

Answer 10

trained staff member monitors patient
sedationist is still available in case of complications
all discharge criteria is met before leaving
provide with written and verbal instructions to patient and escort

Question 11

what is the discharge criteria for sedation

Answer 11

patient orientated in time, place and person
vital signs are stable and within normal limits
pain and discomfort have been addressed
haemostasis achieved
cannula removed
escort present
post-op instructions given

Question 12

what is the clinical governance surrounding sedation

Answer 12

carry out regular audit of sedation practice
ensure that a system of local protocols for care and management of complications is in place
ensure that critical incidents are reported
carry out significant event analysis
ensure the environment is compliant with inspection requirements