Environment, Equipment and Monitoring
Sedation should take place within a specifically designated area of the department, i.e. a procedure room or the resuscitation room where oxygen, suction, reversal agents and advance life support equipment is immediately available.
Table 1
| Cardiac monitor | Laryngeal masks |
| Pulse oximetry | 10 ml syringe |
| BP recording set at 5 minute intervals | Tie |
| Oxygen applied and delivered prior to procedure | Gloves |
| Suction | Tourniquet |
| Tilting trolley | Venflons |
| Bag, value, mask system ventilation (BVM) – appropriate sized masks | Syringes 5 ml, 10 ml |
| Selection OP/nasopharyngeal (NP) airways | Flumazenil |
| ETT size 7,8,9 cuffed | Naloxone |
| Adjuncts – stylet and gum elastic bougie | Running IV line with 500 ml 0.9% saline |
| Short and long blade laryngoscopes | Defibrillator and emergency drug box |
Minimum monitoring requirements during procedural sedation are heart rate, non-invasive blood pressure, respiratory rate and oxygen saturation. The patients sedation level should also be recorded using a recognised scale such as the ASA classification of grades of conscious depression. [13]
Table 2
| Level of sedation ————- Parameter | Minimal sedation(anxiolysis) | Moderate sedation(conscious sedation) | Deep sedation | General anaesthesia |
|---|---|---|---|---|
| Responsiveness | Normal response to verbal stimulation | Purposeful response to verbal or tactile stimulation | Purposeful response after repeated or painful stimulation | Unrousable even with painful stimulus |
| Airway | Unaffected | No intervention required | Intervention may be required | Intervention often required |
| Spontaneous ventilation | Unaffected | Adequate | Maybe inadequate | Frequently inadequate |
| Cardiovascular function | Unaffected | Usually maintained | Usually maintained | Maybe impaired |
Sedation should take place within a specifically designated area where oxygen, suction, reversal agents and advance life support equipment is immediately available.
Learning Bite
Minimum monitoring requirements during procedural sedation are heart rate, non-invasive blood pressure, respiratory rate and oxygen saturation.