Moderate Sedation Certification
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Moderate "Conscious" Sedation - ANS ✅A minimally depressed level of
consciousness induced by the administration of pharmacologic agents in which
the patient retains continuous and independent ability to maintain protective
reflexes and a patent airway and to be aroused by physical or verbal stimulation.
Levels of Sedation Analgesia - ANS ✅1. Minimal Sedation
2. Moderate Sedation/Analgesia
3. Deep Sedation/Analgesia
4. General Anaesthesia
Minimal Sedation - ANS ✅1. Patient is able to respond normally to verbal
stimulation.
2. Airway and Spontaneous Ventilation is not affected and thus "normal"
3. Cardiovascular function is not affected
Moderate Sedation/Analgesia - ANS ✅1. Patient responds to verbal or tactile
stimulation
2. No intervention to maintain patent airway
3. Spontaneous ventilation is adequate
4. Cardiovascular function is usually maintained
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Moderate Sedation Certification
Deep Sedation/Analgesia - ANS ✅1. Patient responds to repeated or painful
stimulation
2. May require intervention to maintain patent airway
3. Spontaneous ventilation may be inadequate
4. Cardiovascular function is usually maintained
General Anaesthesia - ANS ✅1. Patient cannot be aroused, even with painful
stimuli
2. Intervention required to maintain patent airway
3. Spontaneous ventilation is frequently inadequate
4. Cardiovascular function may be impaired
Goals of Safe Sedation - ANS ✅1. Maintain adequate ventilation,
homeostasis, and circulation
2. Maintenance of appropriate level of consciousness
3. Promote comfort by elevating pain threshold
4. Patient Safety-be knowledgeable about possible consequences of respiratory
depression, airway obstruction, apnea, hypoxia, hypercapnia, bradycardia,
asystole, brain injury/death
5. Using the essential components required to conduct safe sedation
6. Understand the importance of a systematic approach to sedation that
promotes safety and efficacy.
Role of the Sedation Nurse - ANS ✅1. Pre-op Nursing Assessment
2. Intra-op Nursing Actions: medication administration; patient monitoring;
patient safety; procedure specific
3. Post-op monitoring during recovery
4. Follow post-op d/c criteria
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5. Explain post-d/c written instructions
6. Follow-up
JCAHO Care Standard: Qualified Individuals conducting sedation must
possess education, training, and experience in? - ANS ✅1. Evaluating
patients prior to moderate or deep sedation
2. Rescuing patients who slip into a "deeper than desired" level of sedation or
anaesthesia
3. Managing a compromised airway during a procedure
4. Handling a compromised CV system during a procedure.
Pre-Operative Nursing Assessment Steps - ANS ✅1. Chart Review
2. Patient Interview
3. Physical Exam and Review of Systems
Pre-sedation Assessment Overview: Parts of the Assessment - ANS ✅1.
NPO Status
2. Chief complaint
3. Current medications
4. Drug allergies
5. H/O substance abuse
6. Concurrent medical problems
7. Communication Ability
How is Aspiration Risk Reduced - ANS ✅1. Pre-procedure fasting--Defined
as no food for 6 hours prior to procedure. May have clear fluids until 2h prior to
procedure.
2. Medication is titrated to maintain reflexes
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Moderate Sedation Certification
What conditions place patient's at enhanced risks for aspiration with
sedation? - ANS ✅1. Obesity
2. DM
3. Pregnancy
4. Bowel Dysfunction
Patient history to consider during pre-op preparation - ANS ✅1. Smoking-
PPD and years
2. Drug allergies and reaction
3. Alcohol Abuse
4. Menstrual Hx and Urine HCG for fertile women
5. Height and Weight to dose medications
6. Drug Abuse
7. Daily Medications
8. Post Facial/Neck Trauma or Surgery
9. Dentures or any removable items in mouth
Elements of Pre-operative Preparation - ANS ✅1. Patient counselling
2. Rapport
3. Verbal reassurance
4. Patient expectations
5. IV Access
6. EKG/BP
7. Pulse Ox
8. Informed Consent
Moderate Sedation Certification
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