MODERATE SEDATION CERTIFICATION (QUESTIONS
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Airway Assessment
Results will indicate the potential ease or difficulty of positive pressure
ventilation. If assessed as having a difficult airway, it is critical that the
patient maintain protective airway reflexes
Airway Assessment: Patient History
1. Problems with anesthesia
2. Stridor, snoring, sleep apnea?
3. Advanced rheumatoid mouth and jaw
Mallampati Airway Assessment
- Accurate predictor of subtle anatomic causes of
difficult intubation
- Classification is made per visualization of the soft palate, uvula,
anterior and posterior tonsillar pillars
Mallampati Class I
Visualize the soft palate, uvula, anterior and posterior tonsillar pillars
Mallampati Class II
Visualize soft palate, fauces, uvula
Mallampati Class III
-Visualize soft palate and base of uvula
-Need anesthesia consultation
,Mallampati Class IV
-The soft palate is not visible at all; only hard palate visible
-Need anesthesia consultation
Airway Assessment Considerations
-Cervical Range of Motion
-Any restrictions with hyperextension of the head and neck
Instructions for patients well controlled on oral hypoglycemic receiving
sedation for short-term period (<1 hour)
1. Do not take normally scheduled AM dose of medication secondary to
long-term effects of possible greater than 36h
2. Finger stick glucose prior to procedure and after the procedure
Instructions for well-controlled insulin dependent DM and for those
procedures that may last longer than 1 hour
1. Consult anesthesia for medication recommendations
2. Usually take normal dose of NPH evening prior and half prescribed AM
dose the morning of
3. Finger stick glucose every 30min. during the procedure and every hour
during recovery
Pre-op Assessment Neurologic System
-H/O TIA, CVA, seizure disorder, head trauma, convulsive disorder or
epilepsy
-Assess general affect and behavior; speech pattern alterations; LOC;
orientation; gait
-If local anesthesia is to be used, assess pre-existing numbness or
weakness
Considerations for hyperthyroidism or hypothyroidism
-Pharmacologic effects of sedative and analgesics may be altered in these
conditions
-Airway management may be more difficult in either situation and the
,thyroid gland may be enlarged in hyperthyroidism and the tongue may be
enlarged in hypothyroidism
Required Equipment for Sedation
-Oxygen Source
-Suction
-Bag valve mask
-Airway adjuncts
-IV access
-Emergency medications
-NIBP
-Pulse Oximeter
-Capnography
-Electrocardiograph
-Crash Cart
Minimal Oxygen Saturation
95% on RA or supplemental O2
Considerations during Induction Phase
-Continuous cardiac monitoring and VS
-Pre and post sedation rhythm strip
LOC most important
Supplemental O2 via NC
-Volume of 1-6L/minute = 24-44% concentration of O2
-FiO2 (% of oxygen) is increased by 4% for each L/Minute (Natural air FiO2
is 20%)
-Mouth breathing does not ablate effectiveness as O2 is entrained from
the nose via inspiratory flow through the posterior pharynx
Supplemental O2 via Simple Face Mask
-Recommended for 8-10 Liters/min (40-60%)
-Flow rate must be at least 5L/min to prevent CO2 rebreathing
, Supplemental O2 via Face Mask with Reservoir
-A flow of 6L/min will allow for O2 concentrations of 60%
-A flow of 10L/min will allow for close to 100%
O2 delivery system recommended in acute and emergent situations
Bag-valve device
Airway Adjuncts for Sedation
-Nasal Airway
-Oral Airway
Airway Adjuncts for Anesthesia
-ETT (absolute control of airway)
-Laryngeal mask airway
Nasal Airway
-Well tolerated by semi-conscious patient
Oral Airway
-Must be measured properly
-Keeps the posterior pharynx open and prevents airway obstruction
-Only used with unresponsive patients as it can otherwise induce
vomiting, laryngospasm, or bronchospasm
-Airway is inserted backwards and rotated into position
Monitoring Parameters
1. Respiratory rate and function
2. SaO2
3. BP
4. LOC
5. Skin condition
6. Continuously placed IV
Desirable Effects of Conscious Sedation
+ ANSWERS) |CORRECT LATEST UPDATED
2026/2027 A COMPLETE SOLUTION ALL ANSWERS
GET IT 100% CORRECT VERIFIED BEST GRADED A+
FOR SUCCESS
Airway Assessment
Results will indicate the potential ease or difficulty of positive pressure
ventilation. If assessed as having a difficult airway, it is critical that the
patient maintain protective airway reflexes
Airway Assessment: Patient History
1. Problems with anesthesia
2. Stridor, snoring, sleep apnea?
3. Advanced rheumatoid mouth and jaw
Mallampati Airway Assessment
- Accurate predictor of subtle anatomic causes of
difficult intubation
- Classification is made per visualization of the soft palate, uvula,
anterior and posterior tonsillar pillars
Mallampati Class I
Visualize the soft palate, uvula, anterior and posterior tonsillar pillars
Mallampati Class II
Visualize soft palate, fauces, uvula
Mallampati Class III
-Visualize soft palate and base of uvula
-Need anesthesia consultation
,Mallampati Class IV
-The soft palate is not visible at all; only hard palate visible
-Need anesthesia consultation
Airway Assessment Considerations
-Cervical Range of Motion
-Any restrictions with hyperextension of the head and neck
Instructions for patients well controlled on oral hypoglycemic receiving
sedation for short-term period (<1 hour)
1. Do not take normally scheduled AM dose of medication secondary to
long-term effects of possible greater than 36h
2. Finger stick glucose prior to procedure and after the procedure
Instructions for well-controlled insulin dependent DM and for those
procedures that may last longer than 1 hour
1. Consult anesthesia for medication recommendations
2. Usually take normal dose of NPH evening prior and half prescribed AM
dose the morning of
3. Finger stick glucose every 30min. during the procedure and every hour
during recovery
Pre-op Assessment Neurologic System
-H/O TIA, CVA, seizure disorder, head trauma, convulsive disorder or
epilepsy
-Assess general affect and behavior; speech pattern alterations; LOC;
orientation; gait
-If local anesthesia is to be used, assess pre-existing numbness or
weakness
Considerations for hyperthyroidism or hypothyroidism
-Pharmacologic effects of sedative and analgesics may be altered in these
conditions
-Airway management may be more difficult in either situation and the
,thyroid gland may be enlarged in hyperthyroidism and the tongue may be
enlarged in hypothyroidism
Required Equipment for Sedation
-Oxygen Source
-Suction
-Bag valve mask
-Airway adjuncts
-IV access
-Emergency medications
-NIBP
-Pulse Oximeter
-Capnography
-Electrocardiograph
-Crash Cart
Minimal Oxygen Saturation
95% on RA or supplemental O2
Considerations during Induction Phase
-Continuous cardiac monitoring and VS
-Pre and post sedation rhythm strip
LOC most important
Supplemental O2 via NC
-Volume of 1-6L/minute = 24-44% concentration of O2
-FiO2 (% of oxygen) is increased by 4% for each L/Minute (Natural air FiO2
is 20%)
-Mouth breathing does not ablate effectiveness as O2 is entrained from
the nose via inspiratory flow through the posterior pharynx
Supplemental O2 via Simple Face Mask
-Recommended for 8-10 Liters/min (40-60%)
-Flow rate must be at least 5L/min to prevent CO2 rebreathing
, Supplemental O2 via Face Mask with Reservoir
-A flow of 6L/min will allow for O2 concentrations of 60%
-A flow of 10L/min will allow for close to 100%
O2 delivery system recommended in acute and emergent situations
Bag-valve device
Airway Adjuncts for Sedation
-Nasal Airway
-Oral Airway
Airway Adjuncts for Anesthesia
-ETT (absolute control of airway)
-Laryngeal mask airway
Nasal Airway
-Well tolerated by semi-conscious patient
Oral Airway
-Must be measured properly
-Keeps the posterior pharynx open and prevents airway obstruction
-Only used with unresponsive patients as it can otherwise induce
vomiting, laryngospasm, or bronchospasm
-Airway is inserted backwards and rotated into position
Monitoring Parameters
1. Respiratory rate and function
2. SaO2
3. BP
4. LOC
5. Skin condition
6. Continuously placed IV
Desirable Effects of Conscious Sedation
