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Sedation . Exclusions from the policy. Patients receiving a single oral medication in standard outpatient dose Patients undergoing minimal sedation. Defined by policy as “one drug, one route, one dose, one time”

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exclusions from the policy
Exclusions from the policy
  • Patients receiving a single oral medication in standard outpatient dose
  • Patients undergoing minimal sedation. Defined by policy as “one drug, one route, one dose, one time”
  • Intubated patients in acute care areas who will be mechanically ventilated during and after the procedure
  • Patients having surgery or other procedures under the care of anesthesia practitioners
anxiolysis minimal sedation
Anxiolysis(minimal sedation)
  • A drug-induced state during which patients respond normally to verbal commands. Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are unaffected.
  • Applies when medication is given prior to a procedure for the purpose of lessening anxiety.
  • The ability to rescue the patient from unintended deeper sedation must be present
moderate conscious sedation
Moderate (Conscious) Sedation
  • A drug induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate.
  • A nurse monitoring the patient can perform brief interruptible tasks to assist the physician.
deep sedation
Deep Sedation
  • A drug induced depression of consciousness during which patients cannot be easily aroused but respond purposefully after repeated or painful stimulation. The ability to maintain ventilatory function may be impaired.
  • The nurse monitoring the patient may not perform tasks other than those related to the administration of sedation.
equipment requirements
Equipment Requirements
  • Crash cart (or appropriate components) with defibrillator
  • Reversal medications
  • Oxygen and Suction
  • Pulse oximeter and automated B/P monitor
pre sedation assessment requirements
Pre-sedation Assessment Requirements
  • Evidence of informed consent inclusive of the risks, benefits and alternatives for sedation and procedure
  • NPO status
  • Weight and age
  • Appropriate History and physical
  • Intended level of sedation
  • Diagnosis / Indication for the procedure / sedation
  • Allergies or prior drug reactions
  • Current medications
  • Current health problems
  • VS prior to sedation
  • ASA Classification
requirements for patient care during sedation
Requirements for Patient care during sedation
  • Physician with appropriate privileges should be immediately available
  • Patent vascular access
  • Continuous HR and O2 sat. monitoring
  • B/P, RR documented q 15 min (moderate sedation), q 5 min. (deep sedation)
  • Documentation of the start and stop time of the procedure
  • Level of sedation (Modified Riker Scale)
  • Post procedure Aldrete Score
modified riker scale
Modified Riker Scale
  • 0= Awake, calm, follows commands
  • -1= Drowsy; will respond to verbal stimuli
  • -2= Arouses to noxious stimuli only
  • -3 Unarousable to any stimuli
requirements for patient care post sedation
Requirements for patient care post sedation
  • B/P, HR, RR, saturation and aldrete score every 15 minutes until recovered
  • Successful completion of a measurable criteria to discharge from procedure to the recovery phase (Aldrete Score)
confirming physician privileges
Confirming Physician Privileges
  • Start using the UCLA Mednet Homepage
  • Click on “QMS- Center for Patient Safety and Quality”
  • Click on “Clinical Privileges”
  • Enter Physician name
  • Delineated privileges appear for each physician