PSA in Adults

Question 1

Use of anxiolytic, sedative, hypnotic & analgesic and/or dissociative meds to attenuate anxiety, pain &/or motion during diagnostic or therapeutic procedure

Answer 1

Procedural Sedation and Analgesia (PSA)

Question 2

Anxiolysis w N or slowed response to stimuli

Answer 2

Minimal sedation

Question 3

Depressed level of consciousness but w slowed purposeful motor response to verbal or tactile stimuli

Answer 3

Moderate sedation

Question 4

State of detachment from immediate surroundings in w/c cortical centers are prevented from receiving sensory stimuli

Answer 4

Dissociation

Question 5

Dissociative sedation is characterized by profound analgesia and amnesia w retention of protective airway reflexes, spontaneous respirations and cardiopulmonary stability. TRUE or FALSE?

Answer 5

TRUE

Question 6

ED PSA agents producing dissociative sedation

Answer 6

Ketamine

Nitrous oxide

Question 7

Profoundly depressed LOC w purposeful motor response ellicited after repeated painful stimuli

Answer 7

Deep sedation

Question 8

Drug-induced LOC during w/c px are not arousable even by painful stimulation

Answer 8

General anesthesia

Question 9

ASA class of healthy px

Answer 9

Class I

Question 10

ASA class of pregnant women

Answer 10

Class II

Question 11

ASA class of moderate - severe asthma

Answer 11

Class III

Question 12

ASA class of controlled diabetes px

Answer 12

Class II

Question 13

ASA class of premature infant w postconceptional age <60 wk

Answer 13

Class III

Question 14

ASA class of obese px

Answer 14

Class II

Question 15

ASA class of ESRD px

Answer 15

Class III

Question 16

ASA Class of mild asthma

Answer 16

Class II

Question 17

ASA class of pneumonia px

Answer 17

Class III

Question 18

ASA class of sepsis & DIC px

Answer 18

Class IV

Question 19

ASA class of severe cardiac dysfx px

Answer 19

Class IV

Question 20

ASA class of px that are moribund & not expected to survive w/o surgery

Answer 20

ASA Class V

Question 21

ASA class of px that have massive trauma

Answer 21

Class V

Question 22

ASA class of px with intracranial hemorrhage w mass effect

Answer 22

Class V

Question 23

ASA class of ischemic bowel w MOD

Answer 23

Class V

Question 24

ASA Class of px who are declared brain dead but w organ for harvesting

Answer 24

Class VI

Question 25

If possible, delay PSA in intoxicated lx until mental status improves. TRUE or FALSE?

Answer 25

TRUE

Question 26

It is necessary to delay ED PSA for time-sensitive procedures based on fasting time. TRUE or FALSE?

Answer 26

FALSE. Not necessary. Preprocedural fasting has not demonstrated any reduction in risk of aspiration.

Question 27

Monitor BP, HR, & RR every __ mins for minimal sedation.

Answer 27

15 mins.

Question 28

Monitor O2 sat continuously for all types of sedation (mild-deep). TRUE or FALSE?

Answer 28

TRUE

Question 29

Have naloxone on hand when using an opioid. Have ______ on hand when using benzodiazepines.

Answer 29

flumazenil

Question 30

For moderate and deep sedation, record BP every __ minutes and after sedative boluses

Answer 30

5 minutes

Question 31

etCO2 >__ indicates hypoventilation

Answer 31

> 10 mmHg

Question 32

Delay start of procedure for __ mins until after peak of effect of fentanyl has been reached

Answer 32

2-3 mins

Question 33

Fentanyl dosage

Answer 33

1-2 mcg/kg