Moderation Sedation/Analgesia (Conscious Sedation) Questions With Complete Solutions Rated A+

Giving sedation safely is critical to: - Answer-- help prevent negative outcomes - comply with regulations - how moderate sedation relates to other types of anesthetic services, and how this relates to patient safety - how JCAHO expects accredited facilities to manage moderate sedation Sedation continuum levels - Answer-1. minimal sedation 2. moderate sedation 3. deep sedation 4. general anesthesia 5. significance minimal sedation - Answer-anxiolysis - the use of drugs to lessen anxiety without lessening awareness - pt feels relaxed, responds normally to speech, thinking and coordination may be affected, breathing and heart function are not affected moderate sedation / analgesia (formely "conscious sedation") - Answer-- patient has depression of consciousness - pt will respond purposefully to spoken words or spoken words w/ a light touch - for this definition, "purposeful" movement does not include reflex movement away from pain - the patient's breathing is adequate - heart function is usually maintained Deep Sedation (analgesia) - Answer-- patient has depression of consciousness and is difficult to awaken - the pt will respond purposefully to repeated or painful stimulation. reflex movement away from pain is not "purposeful" - the pt may need help to keep the airway open- the pt's own breathing my not be adequate - heart function is usually maintained General Anesthesia (deepest form of sedation) - Answer-- patient loses consciousness - the patient cannot be awakened, even by painful stimuli - the patient often needs assistance maintaining the airway and ventilations. Often requires positive pressure ventilation - heart function may be impaired Because sedation is a continuum the response of any one patient may be unpredictable... - Answer-may enter a state of deep sedation instead - moderate sedation should be monitored just as carefully as deep sedation and anesthesia JCAHO Standards for anesthesia services (moderate) - Answer-- sedation must be given by a qualified provider - pt who will receive moderate sedation must be assessed ahead of time - sedation options and risks must be discussed w/ patient and family prior to sedation - patient must be re-assessed immediately before the sedation is given - patient's oxygenation, ventilation and circulation must be monitored during sedation - the pt. must be assessed in the post-sedation recovery area before discharge - a qualified provider must discharge the patient from the post-sedation recovery area, or discharge must be based on established criteria. pre-sedation assessment should include: - Answer-1. indication for procedure 2. determination that pt is an appropriate candidate for sedation and the procedure 3. patient history (allergies, adverse drug events, potential for pregnancy, prior sedative or anesthesia experiences) 4. physical assessment Physical assessment should include: - Answer-1. baseline vital signs and oxygen saturation 2. weight3. airway status 4. appropriate fasting interval 5. aspiration risk factors 6. status of cardiac pulmonary, and neurologic systems 7. mental status and level of consciousness 8. appropriate lab tests 9. ASA status