Being a pro at procedural sedation is a great skill to have. It helps make your job safer and more efficient while also making your patients more comfortable with the process. There’s a lot to know about sedation though, so here’s a brief guide to help you make sure you’re doing everything properly for both yourself and your patients.
The first thing to know is that sedation has multiple definitions. These are defined by the responsiveness and ventilation pattern of the patient and are known as dissociative, moderate and deep sedation. Dissociative sedation is defined by a trance separation with retained airway reflexes and ventilation. Moderate sedation involves depressed consciousness with responses to commands or touch, with no ventilation changes. In deep sedation, patients are aroused by pain and ventilation may be irregular but is intended to be adequate.
What Do You Need?
In order to properly go through with the sedation, you’ll want to make sure you have respiratory therapy, nursing and a second provider if possible. A sedation certified nurse can help push medications at the direction of the physician, making things easier for them, while having another provider present – one for the sedation and one for the procedure – also makes things easier. If alone, make sure you’ll be able to stop the procedure and resuscitate if the need arises.
When preparing for the sedation, do your best to keep everything organized. You’ll want to have the blood pressure cuff on the opposite arm of the IV as well as opening up your fluids. Be sure that the IV flows well before starting as well. Another good tip is to draw up more medications than you expect to use, just in case.
When choosing your medications of choice, be sure to consider your goal depth and duration as well as the characteristics of the patient. While every provider has their own preferences when it comes to medication, it’s always good to be comfortable with multiple options in order to play it safe. The dose you’ll need for a specific level of sedation will be different for every patient, and it should be based on the desired depth of sedation. There are many medications you can use, all with their own suggested doses and concerns to be aware of.