Medicine: Moderate sedation Exam Questions and Answers 100% Pass

Medicine: Moderate sedation Exam Questions and Answers 100% Pass Moderate Sedation Defined: - administration of any medication with sedative/hypnotic properties capable of altering the state of consciousness and/or compromising protective reflexes AMA Office-based Surgery Core Principle #10 - Physicians administering or supervising moderate sedation/analgesia, deep sedation/analgesia, or general anesthesia should have appropriate education and training. Training of personnel - Individuals responsible for patients sedation/analgesia should understand the pharmacology of the agents that are administered and the role of pharmacologic antagonists... They should be able to recognize complications and at least one caregiver should be capable of establishing a patent airway and positive pressure ventilation 2 | P a g e ©All Rights Reserved, 2025 X Emily Charlene Lead Athor Availability of an individual responsible for patient monitoring - A designated individual, *other than the practitioner performing the procedure*, should be present to monitor the patient throughout procedures performed with sedation/analgesia...during moderate sedation, this individual may assist with minor, interruptible tasks once the patient's level of sedation/analgesia and vital signs have stabilized need at least 3 people in room for sx Monitoring Guidelines - Level of consciousness Pulmonary ventilation Oxygenation emodynamics Use of supplemental oxygen - Equipment to administer supplemental oxygen should be present when sedation/analgesia is administered Anesthetic induction agents used for sedation/analgesia (propofol, methohexital, ketamine): - The literature suggests that when administered by non-anesthesiologists, propofol and ketamine can provide satisfactory moderate sedation; however, consultants agree that AVOIDING these medications decreases the likelihood of adverse outcomes during moderate sedation. 3 | P a g e ©All Rights Reserved, 2025 X Emily Charlene Lead Athor Key Elements of JCAHO's Agenda for Moderate Sedation: - Moderate sedation has been identified as a high risk, high volume, problem prone care process. A "single and consistent policy" for the use of moderate sedation across all sites of care. Based on minimum standards established by anesthesiology. Goals Of Moderate Sedation - Patient responds to tactile stimulation Maintains a patent airway Maintains protective reflexes Maintains cardiovascular homeostasis Moderate sedation - purposeful response to command or tactile stimulation deep sedation - not easily aroused, may have purposeful response to strong stimulation, risk of ventilation/airway, and CV compromise American Society of Anesthesiologists (ASA) classification of patient condition: - I Normal, healthy II Mild systemic disease - no limitation in daily activity III Significant systemic disease - limits daily activity IV Life threatening systemic disease V Pre-morbid condition VI Organ harvest 4 | P a g e ©All Rights Reserved, 2025 X Emily Charlene Lead Athor Areas of special emphasis for Evaluation, Assessment, and Anesthetic plan: - Airway Respiratory system Cardiovascular system Systems with the smallest margin for compromise Profoundly affected by moderate sedation medications Imply changes in usual approach (possible Anesthesia consult) Airway Assessment, Physical Exam - Habitus: significant obesity (esp. of neck & face) Head & Neck: short neck, limited neck extension, decreased hyoid-mental distance (<3cm in an adult), neck mass, cervical spine disease or trauma, tracheal deviation, dysmorphic facial features (e.g., Pierre- Robin Syndrome) Mouth: small opening (<3cm in an adult), edentulous, proturding incisors,