Patient evaluation & Monitoring in I.V. Conscious Sedation Flashcards
what is needed for Patient Evaluation
Proper history and physical examination
what can evaluation be useful for?
Prevention
Medical History Questionnaire
A tool to?
Completed by?
Simple format which is?
Two standard formats?
A tool to gather written information about the patient’s health
Completed by the patient or the patient’s guardian
Simple format which is easy to understand
Two standard formats:
short or long
patient interview
An opportunity to review?
Obtain detailed information about?
Cross check any?
Should be conducted by?
Gain greater insight to?
Identifies?
An opportunity to review the responses made on the written
medical questionnaire
Obtain detailed information about specific responses
Cross check any inconsistent responses
Should be conducted by the person planning and administering the anesthetic (That’s you, doctor!!)
Gain greater insight to the magnitude of the problem
Identifies treatment risk
The Physical Exam
Starts when?
Checks for signs of?
Assesses?
Vitals
Starts when patient walks into the room
Checks for signs of underlying illness
Assesses patient general appearance
Vital signs
Mallampati Classification
Components of the Upper Airway
Consultation
Request to the PCP or specialist for? used to?
The consult needs to be:
When appropriate describe what you?
Request to the PCP or specialist for assistance/ information that you will use to manage your patient
The consult needs to be:
Concise
Specific regarding what you want done
When appropriate describe what you plan to do
Educates the PCP
You know more of what he/she does than they know what you do
Consultation
The assistance/information may include:
Providing?
Information pertaining to?
○ Patient’s ability to?
○ Requests?
○ Determine?
The assistance/information may include:
Providing a specific piece of information needed to move forward with
treatment (INR)
Information pertaining to the patients medical condition
○ Patient’s ability to tolerate treatment
○ Requests further information about patients medical condition
○ Determine optimal condition for treatment
Consultation assistance?
The assistance may include:
Request that patient be?
○ example?
Request assistance in?
Provides?
The assistance may include:
Request that patient be optimized prior to treatment
○ Hypertensive patient (lower BP)
Request assistance in management of patient during perioperative period as necessary (insulin regimen for diabetic patient)
Provides feedback to the consultant
Recognition and Assessment
To determine the level of illness the
provider must be able to interpret the
signs and symptoms that indicate an
existing or pending emergent situation
Early signs of serious illness arise from?
examples/ progression?
Early signs of serious illness arise from the CNS
Anxiety
Fear
Nausea
Inadequate blood supply or vital nutrients
○ Oxygen
○ Glucose
Progression of process
Confusion
Agitation
Combative behavior
Lethargy
Coma
skin changes
Diaphoresis (especially of the brow)
Pallor or grayness of face and limbs
○ Signs of extreme Sympathetic nervous system activation
○ Attempt to conserve core circulation
Capillary refill
The time it takes for the pink to return after blanching the palm or a nail
bed
Is prolonged if peripheral circulation is compromised
Color should return in the time it takes to say” capillary refill”
Vital signs
Baseline vital signs when?
Changes can be used to judge?
Correlate t?
Continue monitoring?
Baseline vital signs when patient is seated
Changes can be used to judge the seriousness of the
patient’s condition
Correlate to clinical situation
Continue monitoring throughout the case
possible Symptoms of the patient
May represent?
May represent early signs of an emergent situation
○ Difficulty breathing
○ Shortness of breath
○ Nausea
○ Chest pain or pressure
○ lightheadedness
○ Dizziness
○ Headache
○ Abdominal pain