Moderate Sedation
Moderate sedation, also called conscious sedation, is a drug-induced depression of consciousness that’s used for painful diagnostic and therapeutic procedures and those for which the patient must remain immobile. With moderate sedation, the patient can still respond purposefully to light tactile stimulation and verbal commands. He maintains a patent airway as well as adequate spontaneous ventilations and cardiovascular function.
In addition to the person administering the moderate sedation, this procedure requires the presence of at least one other person capable of establishing a patent airway and administering positive-pressure ventilation to the patient, if necessary.1
The patient receiving moderate sedation requires sedation monitoring before and throughout the procedure as well as during the recovery period. Doctors, nurses, and other health care professionals can administer moderate sedation within their scope of practice.
Equipment
Sedation flow record ▪ positive-pressure oxygen delivery system capable of administering greater than 90% oxygen for at least 60 minutes ▪ supplemental oxygen administration equipment1 ▪ suction apparatus with connected tubing ▪ suction catheter ▪ pulse oximeter ▪ sphygmomanometer and blood pressure cuff or automated blood pressure machine ▪ stethoscope ▪ cardiac monitoring equipment ▪ emergency care supplies or kit with drugs and equipment to establish and maintain an airway and supplies for vascular access and a defibrillator1 ▪ medications and reversal agents, as ordered.
Preparation of Equipment
Make sure the room where the patient will be receiving the sedation has all the necessary equipment. Test all monitoring equipment to ensure that it’s in proper working order before attaching it to the patient.
Implementation
Verify the doctor’s order for moderate sedation.2
Review the patient’s medical record and make sure the following information is documented: any preexisting medical conditions, previous anesthesia and sedation experiences, current medications, allergies, the last time the patient ate or had oral fluids, a recent height and weight, and physical examination findings, including evaluation of the airway and a cardiac and respiratory assessment.1,3
Ensure that informed consent for the procedure to be performed has been obtained and is included in the patient’s medical record.4,5
Confirm the patient’s identity using with at least two patient identifiers according to your facility’s policy.6
Explain the procedure to the patient and his family, and answer their questions to decrease anxiety and increase cooperation.
If the patient is to be discharged less than 12 hours after receiving sedation, verify that arrangements have been made to transport the patient home and that an adult will be available in case complications arise.
Ensure that the patient has had nothing by mouth except for clear liquids and prescribed medications for at least 8 hours before the procedure.
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