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Moderate Sedation > Mod Sed > Flashcards

Mod Sed Flashcards

1
Q

The Pre-Sedation assessment includes

A

PMH, current meds, labs (if indicated) e.g. pregnancy, NPO status, ASA class, airway assessment (Mallampati)

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2
Q

To be NPO for moderate sedation, how long must they have been without clear liquids? Full liquids? Solids?

A

2 hours
4 hours
6 hours

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3
Q

ASA 1

A

No chronic illness, no routine meds, healthy weight, non-smoker

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4
Q

ASA 2

A

Mild Systemic Disease:

  1. Controlled HTN
  2. Type 2 DM
  3. Smoker
  4. Overweight
  5. Non-metastatic carcinoma
  6. Well controlled asthma
  7. Well controlled seizure disorder
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5
Q

ASA 3

A

Severe Systemic Disease:

  1. Poorly controlled HTN
  2. Polypharmacy for cardiac/respiratory/and/or/metabolic disorders
  3. metastatic disease
  4. any angina
  5. controlled insulin dependent diabetes with HTN
  6. Frequent asthma events (unstable ASA 3)
  7. Uncontrolled insulin dependent diabetes (unstable ASA 3)
  8. Severe COPD, multiple inhalers (unstable ASA 3)
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6
Q

ASA 4

A

Severe Systemic Disease that is a Constant Threat to Life

  1. Metastatic disease with severe organ dysfunction
  2. Severe HTN with angina
  3. Recent MI
  4. Any organ failure
  5. Cardiac Transplant List
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7
Q

ASA 5

A

Moribund, Not Expected to Survive

  1. Poorly responsive cardiogenic shock
  2. Ruptured AAA
  3. Severe hypotension
  4. Head trauma with high ICP
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8
Q

What equipment is needed in the room?

A 
R - reversal Meds
O - oxygen
A - Airway Management equipment (BVM, airways, airway adjuncts
M - Monitoring (ekg, BP, Pulse ox, Temp)
S - Suction canister and yaunkauer 
also - CRASH CART
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9
Q

Nasal Cannula

A

Flow rate : 1-6 L/min

O2 %: 21-44

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10
Q

Venturi Mask

A

Flow rate : 4-12 L/min

O2 %: 24-50

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11
Q

Simple Mask

A

Flow rate : 6-10 L/min

O2 %: 35-60

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12
Q

Non-rebreather Mask

A

Flow rate : 6-15 L/min

O2 %: 60-90

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13
Q

BVM

A

Flow rate : 15 L/min

O2 %: 95-100

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14
Q

Factors affecting oxygen uptake

A

Pulmonary Disease
Cardiac Shunt
Alveolar Ventilation
Affects the body’s ability to absorb the oxygen they are receiving

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15
Q

Factors affecting oxygen transport

A 
Anemia
Hemodilution
Decreased pO2
Smoke/gas Poisoning
     Affect the body's ability to attach oxygen to the RBC, or to move the RBC where it needs to go.
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16
Q

Factors affecting oxygen transport

A 
Anemia
Hemodilution
Decreased pO2
Smoke/gas Poisoning
     Affect the body's ability to attach oxygen to the RBC, or to move the RBC where it needs to go.
17
Q

Factors affecting oxygen release

A 
Alkalosis
Hyperventilation
Hypophosphatemia
Hematologic disorders
     Affect the body's ability to get the oxygen off the red blood cell.
18
Q

Valium (Diazepam) reversal med?

A

Romazicon (Flumazenil)

19
Q

Versed (Midazolam) reversal med?

A

Romazicon (Flumazenil)

20
Q

Demerol (Meperidine) reversal med?

A

Narcan (Naloxone)

21
Q

Fentanyl (Sublimaze) reversal med?

A

Narcan (Naloxone)

22
Q

Morphine reversal med?

A

Narcan (Naloxone)

23
Q

Etomidate reversal med?

A

none

24
Q

ketamine reversal med?

A

none

25
Q

diprivan (propofol) reversal med?

A

none

26
Q

Benzodiazepine caution?

A

May potentiate adverse effects of opioids including respiratory depression

27
Q

Opioids caution?

A

Fentanyl causes chest wall rigidity if given too fast
Morphine releases histamines effecting the respiratory system, so use caution when giving morphine to a patient with asthma.

28
Q

Reversal agents caution?

A

Associated with pain, hypertension, tachycardia, and pulmonary edema.

29
Q

Dilute 0.4 mg in 9 mL of NS. Final concentration of 0.04 mg/mL

A

Narcan

30
Q

Slowly administer in 2.5 mL increments q2m until patient is responsive.

A

Narcan

31
Q

Can be given IV, IM, or SQ

A

Narcan and Romazicon

32
Q

Use caution with patients with history of chronic narcotic use/abuse, or history of seizures.

A

Narcan

33
Q

Reversal with this/these drug(s) may cause seizures.

A

Narcan, Romazicon

34
Q

Give 0.2 mg (2 mL). Repeat at 1 min intervals until you achieve desired LOC response.

A

Romazicon

35
Q

Do not exceed 1 mg (10 mL) of this drug in 20 minutes or 2 mgin any hour.

A

Romazicon

36
Q

Use caution with pts who have a current history of seizures, ETOH abuse or chronic benzo use.

A

Romazicon

37
Q

6 P’s of RSI

A 
Preparation
Preoxygenation
Pretreatment
Paralysis
Placement of tube
Post intubation management

Moderate Sedation (1 decks)

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