Date 8/95; Rev.12/97; 7/98; 2/99; 5/01, 3/03, 9/03; 5/04; 8/05; 3/07; 10/08; 10/09; 10/10 Manual of Administrative Policy Source Sedation Committee

Size: px
Start display at page:

Download "Date 8/95; Rev.12/97; 7/98; 2/99; 5/01, 3/03, 9/03; 5/04; 8/05; 3/07; 10/08; 10/09; 10/10 Manual of Administrative Policy Source Sedation Committee"

Transcription

1 Code No. 711 Section Subject Moderate Sedation (formerly termed Conscious Sedation ) Date 8/95; Rev.12/97; 7/98; 2/99; 5/01, 3/03, 9/03; 5/04; 8/05; 3/07; 10/08; Manual of Administrative Policy Source I.Purpose: To establish rational and consistent guidelines for the safe use of moderate sedation (formerly termed conscious sedation ) administered to non-mechanically ventilated patients undergoing invasive diagnostic and therapeutic procedures throughout York Hospital and it ancillary facilities. Moderate sedation (formerly termed conscious sedation ) practices throughout the organization shall be monitored and evaluated by the Chairman of the Department of Anesthesiology in conjunction with representatives of departments in which moderate sedation (formerly termed conscious sedation ) is administered. II. Definition: Moderate sedation (formerly termed conscious sedation ) describes a state of minimally depressed consciousness wherein sedation and/or analgesia are provided during the conduct of unpleasant procedures while maintaining adequate cardiopulmonary function and the ability to respond purposefully to verbal command and/or light tactile stimulation. Moderate sedation (formerly termed conscious sedation )of the patient is generally achieved when there is slurred speech but the patient is able to respond to verbal commands (i.e. "open your eyes"). Inherent in this definition is the assumption that the patient is able to independently maintain a patent airway and adequate oxygenation. Deep sedation is to be avoided. This is a state of depressed consciousness in which the patient s only response is reflex withdrawal from repeated or painful stimulation. Excessive sedation/analgesia may result in cardiac or respiratory depression that must be rapidly recognized and appropriately managed to avoid the risk of hypoxic brain damage, cardiac arrest, or death. Deep sedation is only to be provided by, or under the immediate direction of, a member of the Department of Anesthesiology or someone with appropriate training, experience, and expertise who is approved by the Chairman of Anesthesiology. For the purposes of moderate sedation (formerly termed conscious sedation ), a pediatric patient is defined as any child less than or equal to 12 years of age. Page 1 of 10

2 III. Exclusions 1. Patients not undergoing a diagnostic or therapeutic procedure {eg. light sedation (formerly termed anxiolysis ), postoperative analgesia, sedation for the treatment of insomnia}. 2. One time dosing of a single drug used for light sedation (formerly termed anxiolysis ) or analgesia in a dose appropriate for the unmonitored treatment of insomnia, anxiety or pain. 3. Peripheral nerve blocks, local or topical anesthesia in conjunction with no more than 50% nitrous oxide with oxygen, but no other sedative or analgesic agents administered by any route. 4. Those patients mechanically ventilated in a critical care environment. 5. Patients requiring emergency tracheal intubation. 6. Perioperative management of patients undergoing general anesthesia or major conduction anesthesia. 7. Patients receiving sedation by a member of the Department of Anesthesia who are utilizing approved anesthesia forms and procedures. 8. Emergent procedures IV. Location: Moderate sedation (formerly termed conscious sedation ) may be administered in various locations throughout the organization. The medical director of each department administering moderate sedation (formerly termed conscious sedation ) will be responsible for ensuring that these guidelines are followed. V. Credentialing: Moderate sedation (formerly termed conscious sedation ) will only be ordered and supervised by physicians and dentists who possess the requisite knowledge of the pharmacology of sedative/analgesic medications and their antagonists as well as airway management skills which may be necessary to rescue a patient from a deeper level of sedation than originally planned. Any nurse or technician assisting with the administration of moderate sedation will complete and maintain competency-based education and training. Page 2 of 10

3 VI. Patient Assessment: All patients requiring moderate sedation (formerly termed conscious sedation ) will have an appropriate pre-sedation history, physical examination, and laboratory evaluation. The results of this evaluation will be written in the patient s medical record. Elements of this assessment may include, but are not limited to: focused medical history, review of systems, and physical examination with particular emphasis on the cardiopulmonary system and the airway; base-line vital sign measurement to include age, height, weight, heart rate, blood pressure, respiratory rate, oxygen saturation, and baseline level of consciousness; current medications and a history of any allergic or adverse drug reactions with sedation or anesthesia; time and nature of last oral intake; pregnancy status; history of tobacco, alcohol, or substance use or abuse; and the results of laboratory studies which will impact upon the moderate sedation (formerly termed conscious sedation ) plan. Positive pressure ventilation, with or without endotracheal intubation, may be necessary if airway compromise develops during moderate sedation. This may be more difficult in patients with atypical airway anatomy. Also, some airway abnormalities may increase the likelihood of airway obstruction during spontaneous ventilation. Factors which may be associated with difficulty in airway management include: previous history of difficult intubation stridor, snoring, or obstructive sleep apnea dysmorphic facial features (e.g. Pierre-Robin syndrome, Down s syndrome, or Treacher-Collins syndrome advanced rheumatoid arthritis involving the cervical spine significant obesity, especially if involving the face or neck structures short neck, limited neck extension, short chin, neck mass, or tracheal deviation limited mouth opening, high arched palate, macroglossia, or nonvisible uvula Page 3 of 10

4 In addition, a patient (or his/her guardian, in the case of a child or impaired adult) undergoing moderate sedation (formerly termed conscious sedation ) should be informed of the benefits, risks, and limitations of this therapy, as well as any possible alternatives. This discussion should be appropriately witnessed and documented in the medical record. Lastly, a plan for the patient s moderate sedation (formerly termed conscious sedation ) shall be noted in the medical record and communicated among all care providers. VII. Pre-procedure Fasting: Patients undergoing moderate sedation (formerly termed conscious sedation ) for elective procedures should not eat solid food or drink liquids for a sufficient period of time to allow for gastric emptying before their procedure. In urgent, emergent, or other situations when gastric emptying is impaired (e.g. pregnancy, obesity, diabetes mellitus, or mechanical obstruction), the potential for pulmonary regurgitation of gastric contents must be considered in determining the timing of the procedure and the degree of sedation. Fasting recommendations for elective procedures under moderate sedation (formerly termed conscious sedation ): Solids And Non-clear Liquids* Clear Liquids Adults 6-8 hours or NPO after midnight 2-3 hours Children older than 36 months 6-8 hours 2-3 hours Children aged 6-36 months 6 hours 2-3 hours Children younger than 6 months 4-6 hours 2 hours *this includes milk, formula, and breast milk Page 4 of 10

5 VIII. Equipment and Monitoring: Published data suggest that, in cooperative patients, administration of sedative/analgesic agents by the intravenous route improves patient comfort and satisfaction. Vascular access should be maintained until the patient is no longer at risk for cardiorespiratory depression. In those cases where medications are not administered intravenously e.g. uncooperative patients or certain pediatric patients, an individual with the skills to rapidly establish intravenous access should be immediately available. During moderate sedation (formerly termed conscious sedation ) administration, the following equipment should be used, or be immediately available: oxygen source with available backup. If an oxygen tank is used as the primary oxygen source it should be checked for appropriate volume prior to use. pulse oximeter EKG Monitor blood pressure monitoring device suction intubation equipment, oral/nasal airways, Ambu bag, mask, and reversal agents (e.g. Narcan and Romazicon) Monitoring of the patient is to be continuous throughout the procedure and must be appropriately documented: oxygenation continuously monitored by pulse oximetry and documented every 15 minutes heart rate continuously monitored (via pulse oximeter or EKG monitor if appropriate) and documented every 5 minutes respiratory frequency and adequacy of pulmonary ventilation continuously monitored and documented every 15 minutes blood pressure measured and documented every 5 minutes EKG should be continuously monitored in any patient with pre-existing cardiovascular disease or dysrhythmias or when dysrhythmias are anticipated or detected level of consciousness and pain continuously assessed and documented every 15 minutes. Page 5 of 10

6 IX. Personnel: Sufficient numbers of qualified personnel, in addition to the physician performing the procedure, must be present to: appropriately evaluate the patient prior to beginning moderate sedation (formerly termed conscious sedation ) monitor the patient administer medications recover and discharge the patient from the recovery area Only RNs with ACLS (PALS for pediatric patients) certification and appropriate competency training are permitted to administer sedative or analgesic medications during procedures requiring moderate sedation (formerly termed conscious sedation ). A designated individual, other than the practitioner performing the procedure, must be present to monitor the patient throughout procedures performed under moderate sedation (formerly termed conscious sedation ). The registered nurse managing the care of the patient receiving intravenous moderate sedation medication may not have other responsibilities during the procedure. The registered nurse may not leave the patient unattended or engage in tasks which would compromise continuous monitoring. If at any time during the administration of moderate sedation (formerly termed conscious sedation ) a patient enters a deeper plane or analgesia or sedation than planned that is not easily reversed or manageable by team members, a member of the Department of Anesthesiology should be immediately contacted for assistance via York Hospital extensions or Additionally, a member of the Department of Anesthesiology should be contacted prior to moderate sedation (formerly termed conscious sedation ) administration if any team member has concerns about the appropriateness of this procedure for any patient. X. Drug Administration: The literature supports the use of supplemental oxygen during the use of moderate sedation (formerly termed conscious sedation ). However, it must be appreciated that, by delaying the onset of hypoxemia, supplemental oxygen will delay the detection of apnea by pulse oximetry, emphasizing the importance of monitoring the adequacy of pulmonary ventilation by other means. If hypoxemia is anticipated or develops during the procedure supplemental oxygen should be promptly administered. Page 6 of 10

7 Sedative/analgesic agents: for Pediatric patients (less than 12 years of age), two licensed practitioners (nurse, physician, pharmacist, etc.) must independently calculate the dose volume for each ordered drug and compare answers prior to drug administration to ensure the correct dose is given. During the pre-procedure time-out, verbal confirmation (repeat back) of the doses of sedative agents must occur for all patients prior to drug administration drugs should be administered intravenously in small increments while continually assessing the patient s level of consciousness. Drug doses and time of administration shall be noted on the conscious sedation record. Please consult the drug and dosage recommendations as published by the York Hospital Pharmacy prior to administration. combinations of sedatives and analgesic drugs may increase the likelihood of adverse outcomes. Ideally, each component should be administered individually to achieve the desired effect (e.g. additional analgesic to relieve pain, additional sedative medication to decrease awareness or anxiety). The use of standard fixed drug combinations is discouraged. it is important to allow adequate time for peak drug effects to occur before administration of subsequent doses. This is particularly true in elderly patients, those with impaired renal or hepatic function, or patients with slowed circulations (e.g. CHF) Reversal agents: specific antagonists for narcotics (Narcan) and benzodiazepines (Romazicon) have shorter duration of actions than the agents they antagonize patients must be observed for an appropriate period of time after the last does of an antagonist to ensure that respiratory depression does not recur the need for reversal agents can be minimized by careful titration of sedative/analgesic drugs Page 7 of 10

8 before, or concomitantly with pharmacologic reversal, patients should: (1) be encouraged to breathe deeply, (2) receive positive pressure ventilation if spontaneous ventilation is inadequate, (3) and receive supplemental oxygen. XI. Recovery Care patients should be monitored by an appropriately trained RN until recovery criteria are met the physician who ordered moderate sedation (formerly termed conscious sedation ) should be notified of any adverse events or patient complications, the management of such, and the patient s response. Adverse events include use of reversal agents, severe O2 desaturation, airway rescue, mortality and known or suspected gastric content aspiration. Any adverse event will be noted in the record. oxygenation shall be continuously monitored by pulse oximetry and documented every 15 minutes until the pre-procedure baseline is achieved heart rate shall be continuously monitored by pulse oximetry and documented every 5 minutes until the pre-procedure baseline is achieved respiratory rate and adequacy of pulmonary ventilation shall be continually monitored and documented every 15 minutes until the pre-procedure baseline is achieved blood pressure shall be measured and documented every 5 minutes vital sign monitoring and recording should continue every 15 minutes until the patient is easily arousable and vital signs return to within 20% of preprocedure level outpatients should have well controlled pain, minimal nausea/vomiting, and the ability to ambulate at a baseline level prior to discharge Page 8 of 10

9 patients who receive reversal agents must be monitored for at least 90 minutes following the last dose of drug antagonist and after they have reached their pre-procedure level of consciousness to ensure that cardiopulmonary depression does not recur. Additional monitoring time may be required in certain patients outpatients should be discharged in the company of a responsible adult who will remain with the patient for 24 hours following the procedure. The responsible adult should be given written discharge instructions and should verbalize understanding of these instructions. These instructions are to include the name and phone number/beeper of who is to be contacted if there are any questions or problems a discharge note written by a physician, including the patient s condition at discharge, shall be included in the medical record inpatients may be discharged back to their respective unit once the discharge criteria are met. XII. Quality Management Ongoing review will occur on all areas in which moderate sedation (formerly termed conscious sedation ) is provided in order to evaluate compliance with this policy. Page 9 of 10

10 Guidelines for Moderate Sedation (Previous title: Guidelines for Conscious Sedation) Dosage requirements for sedation generally decrease in elderly, pediatric, debilitated patients and in patients with significant cardiac, pulmonary, hepatic, renal, or CNS disease. Allow sufficient time for drugs to take effect before redosing. Particular care should be exercised with morbidly obese patients due to the increased risk of airway obstruction with rapid oxygen desaturation. Dose recommendations for IM and PO are for single doses only. Do not repeat by this route. Additional sedation should be given I.V. Doses given below can be modified according to the judgment and practice of the prescribing physician. Adult Sedation Drug Route Suggested Dose Onset of Effect Duration Midazolam IV Incremental dose: 1-2 mg min 1-2 hours Total cumulative dose: 5 mg Morphine IV Incremental dose: mg/kg 5-10 min 3-4 hours Total cumulative dose: 0.2 mg/kg IM 0.1 mg/kg min 4-5 hours Fentanyl IV Incremental dose: micrograms 1-3 min min Total cumulative dose: 3 micrograms/kg Ketamine IV 1 2mg/kg 30 seconds min IM 2-4mg/kg x1 dose (use 100mg/ml solution 4 min min to limit pain on injection) Naloxone IV 0.4 mg/ml added to 9ml NSS 1-2 min min 1-2 ml Q 2-3 min Flumazenil IV 0.2 mg x1 then 0.1 mg Q 1 min 2 min min Total cumulative dose: 1 mg Pediatric Sedation (12 years or under) Drug Route Suggested Dose Onset of Effect Duration Midazolam PO Single dose: 0.5 mg/kg (maximum dose 10mg) min 45 min IV Incremental dose: 0.05 mg/kg min 1-2 hours Single dose: 1 mg Total cumulative dose: 5 mg Morphine IV Incremental dose: 0.05 mg/kg 5-10 min 3-4 hours Total cumulative dose: 0.2 mg/kg IM 0.1 mg/kg min 4-5 hours Fentanyl IV Initial dose: 1 microgram/kg 1-3 min min Repeat dose: 0.5 micrograms/kg Q 10 min Total cumulative dose: 2 micrograms/kg (For children < 6 months, use 0.5 micrograms/kg and titrate upward in 0.5 micrograms/kg increments) Ketamine IV 1 2mg/kg 30 seconds min IM 2-4mg/kg x1 dose (use 100mg/ml solution 4 min min to limit pain on injection) Naloxone IV 0.4 mg/ml added to 9ml NSS 1-2 min min 1-2 ml Q 2-3 min Flumazenil IV 0.02 mg/kg, repeat Q 2 min 2 min min Total cumulative dose: 1 mg Date: 9/2008 Page 10 of 10

Sedation is a dynamic process.

Sedation is a dynamic process. 19th Annual Mud Season Nursing Symposium Timothy R. Lyons, M.D. 26 March 2011 To allow patients to tolerate unpleasant procedures by relieving anxiety, discomfort or pain To expedite the conduct of a procedure

More information

Emergency Department Guideline. Procedural Sedation and Analgesia Policy for the Registered Nurse

Emergency Department Guideline. Procedural Sedation and Analgesia Policy for the Registered Nurse Emergency Department Guideline Purpose: To ensure safe, consistent patient monitoring and documentation standards when procedure related sedation and analgesia is indicated. Definitions: Minimal Sedation

More information

DEEP SEDATION TEST QUESTIONS

DEEP SEDATION TEST QUESTIONS Mailing Address: Phone: Fax: The Study Guide is provided for those physicians eligible to apply for Deep Sedation privileges. The Study Guide is approximately 41 pages, so you may consider printing only

More information

Pediatric Sedation Pocket Reference

Pediatric Sedation Pocket Reference Pediatric Sedation Pocket Reference No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopy, recording,

More information

I. Subject. Moderate Sedation

I. Subject. Moderate Sedation I. Subject II. III. Moderate Sedation Purpose To establish criteria for the monitoring and management of patients receiving moderate throughout the hospital Definitions A. Definitions of three levels of

More information

PHYSICIAN COMPETENCY FOR ADULT DEEP SEDATION (Ages 14 and older)

PHYSICIAN COMPETENCY FOR ADULT DEEP SEDATION (Ages 14 and older) Name Score PHYSICIAN COMPETENCY FOR ADULT DEEP SEDATION (Ages 14 and older) 1. Pre-procedure evaluation for moderate sedation should involve all of the following EXCEPT: a) Airway Exam b) Anesthetic history

More information

Administrative Policies and Procedures. Originating Venue: Provision of Care, Treatment and Services Policy No.: PC 2916

Administrative Policies and Procedures. Originating Venue: Provision of Care, Treatment and Services Policy No.: PC 2916 Administrative Policies and Procedures Originating Venue: Provision of Care, Treatment and Services Policy No.: PC 2916 Title: Sedation Cross Reference: Date Issued: 05/09 Date Reviewed: 04/11 Date: Revised:

More information

Bayshore Community Hospital. Riverview Medical Center. Divisions of Meridian Hospitals Corporation

Bayshore Community Hospital. Riverview Medical Center. Divisions of Meridian Hospitals Corporation Bayshore Community Hospital Riverview Medical Center Divisions of Meridian Hospitals Corporation Regional Hospital Policy for Moderate Sedation for Non-Anesthesiologists I. Policy: This policy will explain

More information

Medical Coverage Policy Monitored Anesthesia care (MAC) EFFECTIVE DATE: POLICY LAST UPDATED:

Medical Coverage Policy Monitored Anesthesia care (MAC) EFFECTIVE DATE: POLICY LAST UPDATED: Medical Coverage Policy Monitored Anesthesia care (MAC) EFFECTIVE DATE: 09 01 2004 POLICY LAST UPDATED: 01 08 2013 OVERVIEW Monitored anesthesia care is a specific anesthesia service for a diagnostic or

More information

1. Pre-procedure preparation:

1. Pre-procedure preparation: Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists 1 1. Pre-procedure preparation: There is insufficient published evidence to evaluate the relationship between sedation / analgesia

More information

Attestation for Completion of Procedural Sedation Course for Level I Moderate Procedural Sedation Privileges

Attestation for Completion of Procedural Sedation Course for Level I Moderate Procedural Sedation Privileges Attestation for Completion of Procedural Sedation Course for Level I Moderate Procedural Sedation Privileges I certify that I have completed the following: I have read the PHSW Procedural Sedation Policy

More information

Title/Description: Department: Personnel: Effective Date: Revised: PURPOSE DEFINITIONS

Title/Description: Department: Personnel: Effective Date: Revised: PURPOSE DEFINITIONS Title/Description: Moderate Sedation and Anesthesia Care Department: Organization-wide Personnel: All Individuals Involved in Anesthesia Care Effective Date: 9/90 Revised: 3/94, 12/96, 4/00, 11/02, 02/03,

More information

Conscious Sedation. Edited by D. John Doyle MD PhD FRCPC

Conscious Sedation. Edited by D. John Doyle MD PhD FRCPC Conscious Sedation Edited by D. John Doyle MD PhD FRCPC In memory of: J. Michael de Ungria, MD 1969-2009 Anesthesia Institute The Cleveland Clinic Goals and Objectives: 1. Define Conscious Sedation. 2.

More information

ADMINISTRATIVE POLICY AND PROCEDURE MANUAL. Subject: Moderate Sedation/Analgesia- Procedural ( Conscious Sedation ) Policy

ADMINISTRATIVE POLICY AND PROCEDURE MANUAL. Subject: Moderate Sedation/Analgesia- Procedural ( Conscious Sedation ) Policy BRYN MAWR HOSPITAL LANKENAU HOSPITAL PAOLI HOSPITAL Working Together to Serve the Community ADMINISTRATE POLICY AND PROCEDURE MANUAL Subject: Moderate Sedation/Analgesia- Procedural ( Conscious Sedation

More information

PHYSICIAN PROCEDURAL SEDATION AND ANALGESIA QUIZ

PHYSICIAN PROCEDURAL SEDATION AND ANALGESIA QUIZ PHYSICIAN PROCEDURAL SEDATION AND ANALGESIA QUIZ 1. Which of the following statements are TRUE? (Select ALL that apply) o Sedative/analgesic drugs should be given in small, incremental doses that are titrated

More information

Addendum D. Procedural Sedation Test MERCY MEDICAL CENTER- SIOUX CITY. Procedural Sedation Questions

Addendum D. Procedural Sedation Test MERCY MEDICAL CENTER- SIOUX CITY. Procedural Sedation Questions Addendum D. Procedural Sedation Test MERCY MEDICAL CENTER- SIOUX CITY Procedural Sedation Questions Individuals applying for moderate sedation privileges must achieve a score of 80%. PRACTITIONER NAME

More information

Sedation-Analgesia Patient Evaluation

Sedation-Analgesia Patient Evaluation Getting Started A health care provider with current privileges to administer sedation-analgesia must conduct a pre-procedure evaluation, and obtain informed consent for sedation-analgesia Only patients

More information

Article XIII ANALGESIA, CONSCIOUS SEDATION, DEEP SEDATION, AND GENERAL ANESTHESIA RULES FOR A DENTIST IN AN AMBULATORY FACILITY

Article XIII ANALGESIA, CONSCIOUS SEDATION, DEEP SEDATION, AND GENERAL ANESTHESIA RULES FOR A DENTIST IN AN AMBULATORY FACILITY Article XIII ANALGESIA, CONSCIOUS SEDATION, DEEP SEDATION, AND GENERAL ANESTHESIA RULES FOR A DENTIST IN AN AMBULATORY FACILITY A. DEFINITIONS 1. Analgesia - The diminution of pain or production of increased

More information

IV Sedation & Analgesia Update 2012

IV Sedation & Analgesia Update 2012 IV Sedation & Analgesia Update 2012 Hospital Directive No. 94 1 Read all content before taking test. Click on Right Arrow at top or bottom to advance to next page. 1 Hospital Directive No. 94 Purpose:

More information

TITLE 5 LEGISLATIVE RULE WEST VIRGINIA BOARD OF DENTISTRY SERIES 12 ADMINISTRATION OF ANESTHESIA BY DENTISTS

TITLE 5 LEGISLATIVE RULE WEST VIRGINIA BOARD OF DENTISTRY SERIES 12 ADMINISTRATION OF ANESTHESIA BY DENTISTS TITLE 5 LEGISLATIVE RULE WEST VIRGINIA BOARD OF DENTISTRY SERIES 12 ADMINISTRATION OF ANESTHESIA BY DENTISTS 5-12-1. General. 1.1. Scope. This legislative rule regulates the administration of anesthesia

More information

Procedural Sedation. Conscious Sedation AAP Sedation Guidelines: Disclosures. What does it mean for my practice? We have no disclosures

Procedural Sedation. Conscious Sedation AAP Sedation Guidelines: Disclosures. What does it mean for my practice? We have no disclosures 2016 AAP Sedation Guidelines: What does it mean for my practice? Amber P. Rogers MD FAAP Assistant Professor of Section of Hospital Medicine and Anesthesiology Corrie E. Chumpitazi MD FAAP FACEP Assistant

More information

Sedation in Children

Sedation in Children CHILDREN S SERVICES Sedation in Children See text for full explanation and drug doses Patient for Sedation Appropriate staffing Resuscitation equipment available Monitoring equipment Patient suitability

More information

Last lecture of the day!! Oregon Board of Dentistry, Division 26: Anesthesia, begins on page 43 (last section of Day 1 handout).

Last lecture of the day!! Oregon Board of Dentistry, Division 26: Anesthesia, begins on page 43 (last section of Day 1 handout). Last lecture of the day!! Oregon Board of Dentistry, Division 26: Anesthesia, begins on page 43 (last section of Day 1 handout). Washington - N2O requires 14 hrs - Minimal Sedation 14-21 hrs - Enteral

More information

RECOMMENDATIONS FOR SAFE ADMINISTRATION OF SEDATION AND ANALGESIA (CONSCIOUS SEDATION)

RECOMMENDATIONS FOR SAFE ADMINISTRATION OF SEDATION AND ANALGESIA (CONSCIOUS SEDATION) Page 1 of 1 t~i.iaj RECOMMENDATIONS FOR SAFE ADMINISTRATION OF SEDATION AND ANALGESIA (CONSCIOUS SEDATION) Patient Evaluation -- Monitoring Support Equipment and Emergency Training Clinical Pharmacology

More information

Supportive Data: Purpose:

Supportive Data: Purpose: Sedation/Analgesia Administration for Procedures ~ Pediatric Moderate/Procedural Sedation Manual: Patient Care Category: Pain Management/Sedation & Analgesia Review responsibility: SVP - Medical Affairs;

More information

CHE X CHN X CHS X CHVH X CWH 1 9 CANCELS: 8/6/07; 10/26/10; 5/1/13; 10/23/13 EFFECTIVE:

CHE X CHN X CHS X CHVH X CWH 1 9 CANCELS: 8/6/07; 10/26/10; 5/1/13; 10/23/13 EFFECTIVE: Approved For: X CHE X CHN X CHS X CHVH X CWH Page 1 of 9 TITLE: MODERATE/CONSCIOUS SEDATION Purpose This policy assures the standard of care is consistent for all patients receiving moderate/conscious

More information

Agency 71. Kansas Dental Board (Authorized by K.S.A and (Authorized by K.S.A and

Agency 71. Kansas Dental Board (Authorized by K.S.A and (Authorized by K.S.A and Agency 71 Kansas Dental Board Articles 71-4. CONTINUING EDUCATION REQUIREMENTS. 71-5. SEDATIVE AND GENERAL ANAESTHESIA. 71-11. MISCELLANEOUS PROVISIONS. Article 4. CONTINUING EDUCATION REQUIREMENTS 71-4-1.

More information

MARSHALLTOWN MEDICAL & SURGICAL CENTER Marshalltown, Iowa

MARSHALLTOWN MEDICAL & SURGICAL CENTER Marshalltown, Iowa MARSHALLTOWN MEDICAL & SURGICAL CENTER Marshalltown, Iowa CARE OF PATIENT POLICY & PROCEDURES Policy Number: 4.44 Subject: Policy: Purpose: Moderate (Conscious) Sedation Conscious sedation will be ordered

More information

The Use of Midazolam to Modify Children s Behavior in the Dental Setting. by Fred S. Margolis, D.D.S.

The Use of Midazolam to Modify Children s Behavior in the Dental Setting. by Fred S. Margolis, D.D.S. The Use of Midazolam to Modify Children s Behavior in the Dental Setting by Fred S. Margolis, D.D.S. I. Introduction: One of the most common challenges that the dentist who treats children faces is the

More information

General Pediatric Approach to Sedation in a Community Hospital

General Pediatric Approach to Sedation in a Community Hospital General Pediatric Approach to Sedation in a Community Hospital Guideline developed by Sarah Tariq, MD, in collaboration with the ANGELS team. Last reviewed by Sarah Tariq, MD, September 14, 2016. Preface

More information

61.10 Dental anesthesia certification.

61.10 Dental anesthesia certification. 61.10 Dental anesthesia certification. a. *Definitions. For purposes of this section, the following definitions shall apply: 1. Acceptable accrediting body means an accrediting body which is accepted by

More information

The following criteria must be met in order to obtain pediatric clinical privileges for pediatric sedation.

The following criteria must be met in order to obtain pediatric clinical privileges for pediatric sedation. Pediatric Sedation Sedation of children is different from sedation of adults. Sedatives are generally administered to gain the cooperation of the child. The ability of the child to cooperate depends on

More information

Adult Procedural Sedation A Training Program for Providers

Adult Procedural Sedation A Training Program for Providers Adult Procedural Sedation A Training Program for Providers Adult Procedural Sedation by the Non-Anesthesiologist Guidelines for adult procedural sedation promote safe and effective medical practice: Many

More information

Optimal sedation and management of anxiety in patients undergoing endobronchial ultrasound (EBUS)

Optimal sedation and management of anxiety in patients undergoing endobronchial ultrasound (EBUS) Optimal sedation and management of anxiety in patients undergoing endobronchial ultrasound (EBUS) Georgios Dadoudis Anesthesiologist ICU DIRECTOR INTERBALKAN MEDICAL CENTER Optimal performance requires:

More information

The Commonwealth of Virginia REGULATIONS GOVERNING THE PRACTICE OF DENTISTRY VIRGINIA BOARD OF DENTISTRY Title of Regulations: 18 VAC et seq.

The Commonwealth of Virginia REGULATIONS GOVERNING THE PRACTICE OF DENTISTRY VIRGINIA BOARD OF DENTISTRY Title of Regulations: 18 VAC et seq. The Commonwealth of Virginia REGULATIONS GOVERNING THE PRACTICE OF DENTISTRY VIRGINIA BOARD OF DENTISTRY Title of Regulations: 18 VAC 60-21-10 et seq. Available at: https://www.dhp.virginia.gov/dentistry/

More information

1.3. A Registration standard for conscious sedation has been adopted by the Dental Board of Australia.

1.3. A Registration standard for conscious sedation has been adopted by the Dental Board of Australia. Policy Statement 6.17 Conscious Sedation in Dentistry 1 (Including the ADA Recommended Guidelines for Conscious Sedation in Dentistry and Guidelines for the Administration of Nitrous Oxide Inhalation Sedation

More information

POST TEST: PROCEDURAL SEDATION

POST TEST: PROCEDURAL SEDATION POST TEST: PROCEDURAL SEDATION Name: Date: Instructions: Complete the Post-Test (an 85% is required to pass). If there are areas that you are unsure of, please review the relevant portions of the learning

More information

Regulations: Minimal Sedation. Jason H. Goodchild, DMD

Regulations: Minimal Sedation. Jason H. Goodchild, DMD Regulations: Minimal Sedation Jason H. Goodchild, DMD August 2016 Caveats 1. The regulations about to be presented are accurate and current as of today. 2. This could change tomorrow. 3. It is up to every

More information

Guidelines for the Use of Sedation and General Anesthesia by Dentists

Guidelines for the Use of Sedation and General Anesthesia by Dentists Guidelines for the Use of Sedation and General Anesthesia by Dentists I. INTRODUCTION The administration of local anesthesia, sedation and general anesthesia is an integral part of dental practice. The

More information

GUIDELINES ON CONSCIOUS SEDATION FOR DENTAL PROCEDURES

GUIDELINES ON CONSCIOUS SEDATION FOR DENTAL PROCEDURES AUSTRALIAN AND NEW ZEALAND COLLEGE OF ANAESTHETISTS ABN 82 055 042 852 ROYAL AUSTRALASIAN COLLEGE OF DENTAL SURGEONS ABN 97 343 369 579 Review PS21 (2003) GUIDELINES ON CONSCIOUS SEDATION FOR DENTAL PROCEDURES

More information

Chapter 004 Procedural Sedation and Analgesia

Chapter 004 Procedural Sedation and Analgesia Chapter 004 Procedural Sedation and Analgesia NOTE: CONTENT CONTAINED IN THIS DOCUMENT IS TAKEN FROM ROSEN S EMERGENCY MEDICINE 9th Ed. Italicized text is quoted directly from Rosen s. Key Concepts: 1.

More information

The goal of deep sedation is to achieve a medically controlled state of depressed consciousness from which the patient is not easily aroused.

The goal of deep sedation is to achieve a medically controlled state of depressed consciousness from which the patient is not easily aroused. SUBJECT: Deep Sedation POLICY NUMBER: PAMC/MS 951.139 Policy Type: Patient Care New Revised Reviewed EXECUTIVE Approval: Date Signed: 10.29.2014 /s/ Richard D. Mandsager, MD, Chief Executive Providence

More information

Trust Policy. Title: Sedation Policy for Adult Patients. Key Points

Trust Policy. Title: Sedation Policy for Adult Patients. Key Points Trust Policy Title: Sedation Policy for Adult Patients Authors: Barry Nicholls, Consultant Anaesthetist & Jon Beard, Chief Pharmacist Policy Lead: Barry Nicholls, Consultant Anaesthetist Ratified by: Policy

More information

Pain & Sedation Management in PICU. Marut Chantra, M.D.

Pain & Sedation Management in PICU. Marut Chantra, M.D. Pain & Sedation Management in PICU Marut Chantra, M.D. Pain Diseases Trauma Procedures Rogers Textbook of Pediatric Intensive Care, 5 th ed, 2015 Emotional Distress Separation from parents Unfamiliar

More information

See Policy CPT CODE section below for any prior authorization requirements. This policy applies to:

See Policy CPT CODE section below for any prior authorization requirements. This policy applies to: Effective Date: 1/1/2019 Section: MED Policy No: 108 Medical Officer 1/1/19 Date Medical Policy Committee Approved Date: 6/12; 9/12; 7/13; 10/13; 12/13; 11/14; 1/15; 12/15; 4/16; 12/16; 7/17; 8/17; 12/17;

More information

ADVENTIST HEALTHCARE SHADY GROVE MEDICAL CENTER PATIENT CARE POLICY MANUAL SEDATION/ANALGESIA Effective Date: October 1993 Policy No:

ADVENTIST HEALTHCARE SHADY GROVE MEDICAL CENTER PATIENT CARE POLICY MANUAL SEDATION/ANALGESIA Effective Date: October 1993 Policy No: PURPOSE PEOPLE AFFECTED SUPPORTIVE DATA Page: 1 of 26 To optimize patient safety by establishing consistent hospital-wide processes for the management of patients receiving procedural sedation by non-anesthesiologists.

More information

AMENDMENT TO THE REGULATIONS OF THE COMMISSIONER OF EDUCATION. Pursuant to sections 207, 6504, 6506, 6507, 6601, and 6605-a of the Education

AMENDMENT TO THE REGULATIONS OF THE COMMISSIONER OF EDUCATION. Pursuant to sections 207, 6504, 6506, 6507, 6601, and 6605-a of the Education AMENDMENT TO THE REGULATIONS OF THE COMMISSIONER OF EDUCATION Pursuant to sections 207, 6504, 6506, 6507, 6601, and 6605-a of the Education Law 1. Subdivision (a) of section 61.10 of the Regulations of

More information

CalvertHealth Medical Center s Moderate Sedation Competency Examination

CalvertHealth Medical Center s Moderate Sedation Competency Examination Medical Staff Office Use Only: Congratulations! You passed the Moderate Sedation Competency Examination. Enclosed is the test for your follow-up review. Test Results: % ( of 35 correct) Your test result

More information

Case scenarios. We want to do head CT in an middle-aged woman with agitation and confusion. She does not stay still in the CT table.

Case scenarios. We want to do head CT in an middle-aged woman with agitation and confusion. She does not stay still in the CT table. Procedural sedation Khrongwong Musikatavorn, M.D. Emergency Medicine Unit, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University Case scenarios We need to rule out acute

More information

Last lecture of the day!! WASHINGTON ADMINISTRATIVE CODE ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES

Last lecture of the day!! WASHINGTON ADMINISTRATIVE CODE ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES Last lecture of the day!! WASHINGTON ADMINISTRATIVE CODE ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES February 2017 Washington - N2O requires 14 hrs - Minimal Sedation 14-21 hrs - Enteral

More information

Adult Procedural Moderate and Deep Sedation: A Training Program for Emergency Medicine Physicians

Adult Procedural Moderate and Deep Sedation: A Training Program for Emergency Medicine Physicians Adult Procedural Moderate and Deep Sedation: A Training Program for Emergency Medicine Physicians Adult Procedural Sedation by the Non-Anesthesiologist Guidelines for adult procedural sedation promote

More information

Procedural Sedation in the Rural ER

Procedural Sedation in the Rural ER Procedural Sedation in the Rural ER Hal Irvine MD FCFP Rural FP Anesthetist Sundre, Alberta June 17, 2011 Disclosure I do not have any affiliations (financial or otherwise) with a commercial organization

More information

201 KAR 8:550. Anesthesia and sedation.

201 KAR 8:550. Anesthesia and sedation. 201 KAR 8:550. Anesthesia and sedation. RELATES TO: KRS 313.035 STATUTORY AUTHORITY: KRS 313.035(1) NECESSITY, FUNCTION AND CONFORMITY: KRS 313.035(1) requires the board to promulgate administrative regulations

More information

Sedative-Hypnotics. Sedative Agents (General Considerations)

Sedative-Hypnotics. Sedative Agents (General Considerations) Sedative Agents (General Considerations) No best sedative agent Any agent given in sufficient dosage can produce any level of sedation Intravenous dosing is more predictable then intramuscular or oral

More information

Pain Module. Opioid-RelatedRespiratory Depression (ORRD)

Pain Module. Opioid-RelatedRespiratory Depression (ORRD) Pain Module Opioid-RelatedRespiratory Depression (ORRD) Characteristics of patients who are at higher risk for Opioid- Related Respiratory Depression (ORRD) Sleep apnea or sleep disorder diagnosis : typically

More information

Subspecialty Rotation: Anesthesia

Subspecialty Rotation: Anesthesia Subspecialty Rotation: Anesthesia Faculty: John Heaton, M.D. GOAL: Maintenance of Airway Patency and Oxygenation. Recognize and manage upper airway obstruction and desaturation. Recognize and manage upper

More information

Note: Press F11 to maximize. Physician Education Procedural Sedation for ESJH

Note: Press F11 to maximize. Physician Education Procedural Sedation for ESJH Note: Press F11 to maximize. Physician Education Procedural Sedation for ESJH 1 Definitions along the Sedation Continuum Responsiveness Airway Spontaneous Ventilation Cardiovascular Function Minimal Sedation

More information

Minimal & Moderate Sedation. Focus on British Columbia

Minimal & Moderate Sedation. Focus on British Columbia Minimal & Moderate Sedation Focus on British Columbia Continuum of Sedation in BC Single Oral Sedative Nitrous Oxide & Oxygen Single Oral Sedative and Nitrous Oxide & Oxygen Moderate Sedation Minimal Sedation

More information

To the Medical Staff/Allied Health Professional of Nationwide Children s Hospital:

To the Medical Staff/Allied Health Professional of Nationwide Children s Hospital: To the Medical Staff/Allied Health Professional of Nationwide Children s Hospital: As many of you know, our medical practices in various areas are coming under closer scrutiny of credentialing organizations

More information

EDUCATIONAL REQUIREMENTS FOR NITROUS OXIDE, MINIMAL SEDATION, MODERATE SEDATION & GENERAL ANESTHESIA PERMITS

EDUCATIONAL REQUIREMENTS FOR NITROUS OXIDE, MINIMAL SEDATION, MODERATE SEDATION & GENERAL ANESTHESIA PERMITS EDUCATIONAL REQUIREMENTS FOR NITROUS OXIDE, MINIMAL SEDATION, MODERATE SEDATION & GENERAL ANESTHESIA PERMITS No dentist or dental hygienist will be granted a permit to administer sedation or general anesthesia

More information

Guidelines for Safe Sedation for diagnostic and therapeutic procedures

Guidelines for Safe Sedation for diagnostic and therapeutic procedures Page 1 of 14 Guidelines for Safe Sedation for diagnostic and Version Effective Date OCT 1992 1 (reviewed Feb 2002) 2 APR 2012 3 Document Number Prepared by College Guidelines Committee Endorsed by HKCA

More information

Case. You plan to perform an EGD for further evaluation. Footer text is edited under "view/header and footer" menu August 11, 2018 Page 2

Case. You plan to perform an EGD for further evaluation. Footer text is edited under view/header and footer menu August 11, 2018 Page 2 Procedural Sedation Daniela Jodorkovsky M.D. Gastroenterology Fellowship Director Assistant Professor Medicine Columbia University Medical Center-New York Presbyterian NYSGE First Year Fellow Course 2018

More information

Regulations: Adult Minimal Sedation

Regulations: Adult Minimal Sedation Regulations: Adult Minimal Sedation Jason H. Goodchild, DMD DrGoodchild@yahoo.com April 2017 Regulations Caveats 1. The regulations about to be presented are accurate and current as of today. 2. This could

More information

SENATE BILL No. 501 AMENDED IN SENATE MAY 1, 2017 AMENDED IN SENATE APRIL 20, 2017 AMENDED IN SENATE APRIL 17, Introduced by Senator Glazer

SENATE BILL No. 501 AMENDED IN SENATE MAY 1, 2017 AMENDED IN SENATE APRIL 20, 2017 AMENDED IN SENATE APRIL 17, Introduced by Senator Glazer AMENDED IN SENATE MAY 1, 2017 AMENDED IN SENATE APRIL 20, 2017 AMENDED IN SENATE APRIL 17, 2017 SENATE BILL No. 501 Introduced by Senator Glazer February 16, 2017 An act to amend Sections 1601.4, 1646,

More information

Council on Dental Education and Licensure. Proposed Revisions:

Council on Dental Education and Licensure. Proposed Revisions: Council on Dental Education and Licensure Proposed Revisions: ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists and ADA Guidelines for Teaching Pain Control and Sedation to Dentists

More information

College of Chiropodists of Ontario

College of Chiropodists of Ontario College of Chiropodists of Ontario Standard of Practice for the Administration of Inhaled Substances and the Use of Sedation in a Member s Practice* INTRODUCTION This document represents the minimum standards

More information

MANITOBA DENTAL ASSOCIATION Board Approval for Bylaw Distribution: 26 January 2017

MANITOBA DENTAL ASSOCIATION Board Approval for Bylaw Distribution: 26 January 2017 MANITOBA DENTAL ASSOCIATION THE BYLAW FOR PHARMACOLOGICAL BEHAVIOUR MANAGEMENT MANITOBA DENTAL ASSOCIATION Board Approval for Bylaw Distribution: 26 January 2017 202-1735 Corydon Avenue, Winnipeg, MB,

More information

POLICY and PROCEDURE

POLICY and PROCEDURE Misericordia Community Hospital Administration of Intravenous FentaNYL During Labour POLICY and PROCEDURE Labour and Delivery Manual Original Date Revised Date Approved by: Director, Women s Health, Covenant

More information

SEDATION FOR PROCEDURES- MODERATE AND DEEP CLINICAL POLICY/PROCEDURES MANUAL AND MEDICAL STAFF. Approval

SEDATION FOR PROCEDURES- MODERATE AND DEEP CLINICAL POLICY/PROCEDURES MANUAL AND MEDICAL STAFF. Approval TITLE: MANUAL: SEDATION FOR PROCEDURES- MODERATE AND DEEP CLINICAL POLICY/PROCEDURES MANUAL AND MEDICAL STAFF Effective Date: 3/90 Revised: 2/93, 1/96, 5/96, 4/98, 11/98, 10/00, 1/01, 6/03, 12/04, 5/11,

More information

Regulations: Adult Minimal Sedation. Jason H. Goodchild, DMD.

Regulations: Adult Minimal Sedation. Jason H. Goodchild, DMD. Regulations: Adult Minimal Sedation Jason H. Goodchild, DMD DrJGoodchild@gmail.com October 2017 www.bestdentalce.com www.bestdentalce.com Caveats 1. The regulations about to be presented are accurate and

More information

Sedation for Non-Anesthesia Practitioners

Sedation for Non-Anesthesia Practitioners Endorsed By: CHS Cleveland Interdisciplinary Policy & Procedure Committee Approved By: CHS Cleveland Corporate Steering Committee Date: 8/11 Date: 9/11 Page: 1 of 15 Written By: Marvi LaMagna, Special

More information

King Faisal Specialist Hospital & Research Center Nursing Development & Saudization. Procedural Sedation Self Study Module

King Faisal Specialist Hospital & Research Center Nursing Development & Saudization. Procedural Sedation Self Study Module King Faisal Specialist Hospital & Research Center Nursing Development & Saudization Procedural Sedation Self Study Module 1. Introduction This self-study module is designed to increase and reinforce with

More information

ASPIRUS WAUSAU HOSPITAL, INC. Passion for excellence. Compassion for people. SUBJECT: END TIDAL CARBON DIOXIDE MONITORING (CAPNOGRAPHY)

ASPIRUS WAUSAU HOSPITAL, INC. Passion for excellence. Compassion for people. SUBJECT: END TIDAL CARBON DIOXIDE MONITORING (CAPNOGRAPHY) Passion for excellence. Compassion for people. P&P REF : NEW 7-2011 ONBASE POLICY ID: 13363 REPLACES: POLICY STATUS : FINAL DOCUMENT TYPE: Policy EFFECTIVE DATE: 4/15/2014 PROPOSED BY: Respiratory Therapy

More information

Anesthesia for Routine Gastrointestinal Endoscopic Procedures (Additional description)

Anesthesia for Routine Gastrointestinal Endoscopic Procedures (Additional description) Anesthesia for Routine Gastrointestinal Endoscopic Procedures (Additional description) Date of Origin: 05/2012 Last Review Date: 12/06/2017 Effective Date: 01/01/2018 Dates Reviewed: 12/2013, 11/2014,

More information

Date Dear UCSD Health Care Provider:

Date Dear UCSD Health Care Provider: Date Dear UCSD Health Care Provider: The use of moderate sedation has increased considerably over recent years. As a result, medical centers are under obligation by regulatory requirements, JCAHO, and

More information

MANITOBA DENTAL ASSOCIATION Board Approval for Bylaw Distribution: 04 November 2016

MANITOBA DENTAL ASSOCIATION Board Approval for Bylaw Distribution: 04 November 2016 MANITOBA DENTAL ASSOCIATION THE BYLAW FOR PHARMACOLOGICAL BEHAVIOUR MANAGEMENT MANITOBA DENTAL ASSOCIATION Board Approval for Bylaw Distribution: 04 November 2016 202-1735 Corydon Avenue, Winnipeg, MB,

More information

STANDARD OF PRACTICE. Use of Sedation and General Anesthesia in Dental Practice INTRODUCTION CONTENTS. This document is the standard of practice

STANDARD OF PRACTICE. Use of Sedation and General Anesthesia in Dental Practice INTRODUCTION CONTENTS. This document is the standard of practice Use of Sedation and General Anesthesia in Dental Practice 25 231 STANDARD OF PRACTICE Use of Sedation and General Anesthesia in Dental Practice Approved by Council June 2012 Revised - April 2015 This is

More information

Interfacility Protocol Protocol Title:

Interfacility Protocol Protocol Title: Interfacility Protocol Protocol Title: Mechanical Ventilator Monitoring & Management Original Adoption Date: 05/2009 Past Protocol Updates 05/2009, 12/2013 Date of Most Recent Update: March 23, 2015 Medical

More information

Procedural Sedation and Analgesia in the ED

Procedural Sedation and Analgesia in the ED Overview Procedural Sedation and Analgesia in the ED Susan Lambe, MD Assistant Clinical Professor UCSF Division of Emergency Medicine Terminology Goals Indications Presedation Assessment Consent Issues

More information

INTUBATION/RSI. PURPOSE: A. To facilitate secure, definitive control of the airway by endotracheal intubation in an expeditious and safe manner

INTUBATION/RSI. PURPOSE: A. To facilitate secure, definitive control of the airway by endotracheal intubation in an expeditious and safe manner Manual: LifeLine Patient Care Protocols Section: Adult/Pediatrics Protocol #: AP1-009 Approval Date: 03/01/2018 Effective Date: 03/05/2018 Revision Due Date: 12/01/2018 INTUBATION/RSI PURPOSE: A. To facilitate

More information

SEDATION IN CHILDREN

SEDATION IN CHILDREN Overview Definition Indications Risks Contraindications Pre-sedation Evaluation NBM / fasting recommendations for elective procedures Procedures relating to sedation Call for Help Recovery and Discharge

More information

IFT1 Interfacility Transfer of STEMI Patients. IFT2 Interfacility Transfer of Intubated Patients. IFT3 Interfacility Transfer of Stroke Patients

IFT1 Interfacility Transfer of STEMI Patients. IFT2 Interfacility Transfer of Intubated Patients. IFT3 Interfacility Transfer of Stroke Patients IFT1 Interfacility Transfer of STEMI Patients IFT2 Interfacility Transfer of Intubated Patients IFT3 Interfacility Transfer of Stroke Patients Interfacility Transfer Guidelines IFT 1 TRANSFER INTERFACILITY

More information

Nursing Professional Development Competency Assessment: Moderate Sedation

Nursing Professional Development Competency Assessment: Moderate Sedation COMPETENCY ASSESSMENT PROCESS Type (Code) Assessment Method (Code) Satisfactory Needs Practice GUDE FOR COMPETENCY ASSESSMENT Nursing Professional Development Competency Assessment: Moderate Sedation Name:

More information

PROCEDURAL SEDATION AND ANALGESIA

PROCEDURAL SEDATION AND ANALGESIA Society of Rural Physicians of Canada 26TH ANNUAL RURAL AND REMOTE MEDICINE COURSE ST. JOHN'S NEWFOUNDLAND AND LABRADOR APRIL 12-14, 2018 Dr. Braam de Klerk VICTORIA BC 260 PROCEDURAL SEDATION AND ANALGESIA

More information

Procedural Sedation A/Prof Vasilios Nimorakiotakis (Bill Nimo) Deputy Director Clinical Associate Professor

Procedural Sedation A/Prof Vasilios Nimorakiotakis (Bill Nimo) Deputy Director Clinical Associate Professor Procedural Sedation A/Prof Vasilios Nimorakiotakis (Bill Nimo) MBBS, FACEM, FACRRM, Dip Mgt Deputy Director Emergency Department Epworth Richmond Clinical Associate Professor The University of Melbourne

More information

Hypertensive crisis Acute allergic reaction

Hypertensive crisis Acute allergic reaction Board of Dental Examiners of Alabama Administrative Rule 270-X-2-.17: Criteria For On-Site Inspection For The Use Of General Anesthesia And Parenteral/Moderate Sedation This rule contains the procedures,

More information

Analgesic-Sedatives Drug Dose Onset

Analgesic-Sedatives Drug Dose Onset Table 4. Commonly used medications in procedural sedation and analgesia Analgesic-Sedatives Fentanyl Morphine IV: 1-2 mcg/kg Titrate 1 mcg/kg q3-5 minutes prn IN: 2 mcg/kg Nebulized: 3 mcg/kg IV: 0.05-0.15

More information

Anthem Midwest Clinical Claims Edit

Anthem Midwest Clinical Claims Edit Please compare the claim's date of adjudication to the range of the edit in question. Prior versions, if any, can be found below. Subject: Noninvasive Ear or Pulse Oximetry with Evaluation and Management

More information

SINAI HOSPITAL OF BALTIMORE PATIENT CARE SERVICES POLICY AND PROCEDURE MANUAL

SINAI HOSPITAL OF BALTIMORE PATIENT CARE SERVICES POLICY AND PROCEDURE MANUAL SINAI HOSPITAL OF BALTIMORE PATIENT CARE SERVICES POLICY AND PROCEDURE MANUAL SUBJECT: SCOPE: Moderate (Procedural) Sedation Medical Center Complex PURPOSE: To provide a standard of care for sedation prior

More information

Rapid Sequence Induction

Rapid Sequence Induction Rapid Sequence Induction Virtual simultaneous administration, after preoxygenation, of a potent sedative agent and a rapidly acting neuromuscular blocking agent to facilitate rapid tracheal intubation

More information

CENTRAL IOWA HEALTHCARE Marshalltown, Iowa

CENTRAL IOWA HEALTHCARE Marshalltown, Iowa CENTRAL IOWA HEALTHCARE Marshalltown, Iowa CARE OF PATIENT POLICY & PROCEDURES Policy Number: 4.44 Subject: Purpose: Policy: Procedural Sedation (Adult/Pediatric) To establish appropriate standards for

More information

Maria Tracey, Director-Perioperative and Elaine Warren, Directory-Surgery Level. III (Three)

Maria Tracey, Director-Perioperative and Elaine Warren, Directory-Surgery Level. III (Three) PAGE 1/6 MANAGEMENT OF ADULT SURGICAL CLIENTS WITH KNOWN OR SUSPECTED OBSTRUCTIVE SLEEP APNEA (OSA) Patient Care Issuing Authority Dr. James Flynn, Clinical Chief Surgical Services (Perioperative) Signed

More information

Pediatric Dental Sedation

Pediatric Dental Sedation Pediatric Dental Sedation L. Stephen Long, MD Pediatric Anesthesiologist Children s Dental Anesthesia Group UCSF Benioff Children s Hospital Oakland Part 1: Pediatric Airways and Lungs 1 Three questions:

More information

Moderate Sedation: Risks and Challenges

Moderate Sedation: Risks and Challenges Moderate Sedation: Risks and Challenges WWW.RN.ORG Reviewed May, 2017, Expires May, 2019 Provider Information and Specifics available on our Website Unauthorized Distribution Prohibited Developed by Melissa

More information

PROCEDURAL SEDATION (PS) FOR NON-ANESTHESIOLOGISTS

PROCEDURAL SEDATION (PS) FOR NON-ANESTHESIOLOGISTS PROCEDURAL SEDATION (PS) FOR NON-ANESTHESIOLOGISTS 1. INTRODUCTION This policy is designed to provide specific recommendations for the safe care of adult and children (Appendix I) patients receiving sedation

More information

GUIDELINES FOR THE MODALITIES OF CONSCIOUS SEDATION, DEEP SEDATION OR GENERAL ANESTHESIA FOR A DENTAL PRACTICE OUTSIDE OF A HOSPITAL SETTING

GUIDELINES FOR THE MODALITIES OF CONSCIOUS SEDATION, DEEP SEDATION OR GENERAL ANESTHESIA FOR A DENTAL PRACTICE OUTSIDE OF A HOSPITAL SETTING GUIDELINES FOR THE MODALITIES OF CONSCIOUS SEDATION, 300 PREAMBLE Taking into account the information actually available today and the factors relative to accessibility to care, the Ordre des dentistes

More information

PROPOSED REGULATION OF THE BOARD OF DENTAL EXAMINERS OF NEVADA. LCB File No. R October 26, 1999

PROPOSED REGULATION OF THE BOARD OF DENTAL EXAMINERS OF NEVADA. LCB File No. R October 26, 1999 PROPOSED REGULATION OF THE BOARD OF DENTAL EXAMINERS OF NEVADA LCB File No. R005-99 October 26, 1999 EXPLANATION Matter in italics is new; matter in brackets [omitted material] is material to be omitted.

More information

1. Patient safety 2. Patient comfort. Minimal Sedation (anxiolysis) Moderate Sedation Deep Sedation Anesthesia

1. Patient safety 2. Patient comfort. Minimal Sedation (anxiolysis) Moderate Sedation Deep Sedation Anesthesia Goals of sedation: 1. Patient safety 2. Patient comfort Conscious Sedation Minimal Sedation (anxiolysis) Moderate Sedation Deep Sedation Anesthesia 1 Minimal Sedation (Anxiolysis) Patients respond normally

More information

Moderate and Deep Sedation Pathway

Moderate and Deep Sedation Pathway A Quick Reference to the Advocate System Sedation Policy *This information is meant as a guideline only and not a substitute for physician order or clinical judgment Introduction: This Pediatric Emergency

More information

DRAFT STANDARD OF PRACTICE. Use of Sedation and General Anesthesia in Dental Practice CONTENTS INTRODUCTION

DRAFT STANDARD OF PRACTICE. Use of Sedation and General Anesthesia in Dental Practice CONTENTS INTRODUCTION Use of Sedation and General Anesthesia in Dental Practice 1 STANDARD OF PRACTICE Approved by Council Month 2018 Use of Sedation and General Anesthesia in Dental Practice This is replacing the document

More information