1|Page
Medicine: Moderate sedation REAL
EXAM 85 QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS)|AGRADE
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...
Katelyn Whitman© 2025, All Rights Reserved.
,2|Page
They should be able to recognize complications and at least one caregiver should be capable of
establishing a patent airway and positive pressure ventilation
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.
Katelyn Whitman© 2025, All Rights Reserved.
, 3|Page
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
Areas of special emphasis for Evaluation,
Assessment, and Anesthetic plan: - ✔✔Airway
Katelyn Whitman© 2025, All Rights Reserved.
Medicine: Moderate sedation REAL
EXAM 85 QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS)|AGRADE
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...
Katelyn Whitman© 2025, All Rights Reserved.
,2|Page
They should be able to recognize complications and at least one caregiver should be capable of
establishing a patent airway and positive pressure ventilation
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.
Katelyn Whitman© 2025, All Rights Reserved.
, 3|Page
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
Areas of special emphasis for Evaluation,
Assessment, and Anesthetic plan: - ✔✔Airway
Katelyn Whitman© 2025, All Rights Reserved.
