Moderate Sedation EXAM(Graded A+ actual test)

Moderate sedation - Answer-Patients requiring temporary sedation to facilitate diagnostic or therapeutic procedure Sedation - Answer-any medication with sedative/hypnotic properties is capble of altering conciousness or protective reflexes Training for Personnel - Answer-Should be able to recognize complications and be capable of establishing a patient airway and positive pressure ventilation Patient Monitor - Answer-an individual, other than the practiioner performin the procedure should be present to monitor the patient through the operation with sedation/analgesia during moderate sedation. they MAY assist with minor, interruptable tasks one pation is stablized Monitering Guildilnes - Answer-Level of consciousness: - Response of patient to commands is a guide to level of consciousness. - Spoken = breathing - Reflex only = deep sedation Pulmonary Ventilation: - Primary causes of morbidity are drug induced respiratory depression and airway obstruction Oxygenation - Answer-- Oximetry effectively detects oxygen desaturation and hypoxemia - Supplemental oxygen should be present when sedation/analgesia is administered Hemodynamics - Answer-Regular monitering of vital signs in 5 min intervals, once sedation is established. Anesthetic induction agents - Answer-PropofolMethohexital Ketamine Propofol and ketamine - Answer-- can provide moderate sedation - avoiding these meds will decrease likelyihood of adverse outcomes though JCAHO Agenda for Moderate Sedation - Answer-Standards held for sedated patients under anesthesia care must apply to all sedated patients - Regardless of care giver Goals of Moderate Sedation - Answer-1. Patient Responds to tactile stimulation 2. Maintains a Patient Airway 3. Maintains protective reflexes 4. Maintains CV homeostasis Sedation Continuum - Answer-Moderate Sedation - Deep Sedation - General Moderate sedation signs - Answer-purposeful response to command or tactile stimulation Deep Sedation signs - Answer-not easily aroused, may have purposeful response to strong stimulation, risk of ventilation/airway, and CV compromise ASA classification - Answer-I Normal, healthy II Mild systemic disease - no limitation in daily activity III Significant systemic disease - limits daily activity IV Life threatening systemic diseaseV Pre-morbid condition VI Organ harvest Special Emphasis for Evaluation and Anesthetic Plan - Answer-- Airway - Respiratory system - Cardiovascular system Airway Assesment - Answer-Physical Exam History Anatomical changes Diagnostic testing Mallampati Classification Theyromental Distance Atlanto-occiptal joint distance