Moderate (Conscious) Sedation Protocol
[Pages:39]Moderate (Conscious) Sedation Protocol
Prepared by Dept of Anesthesiology
Jamie Doyle, MD Gene Tom, MD
Copyright ? 2005 Southeast Anesthesiology Consultants, P.A.
Objectives
? Sedation definitions ? Pre-operative evaluation ? Drugs utilized ? Airway management
Copyright ? 2005 Southeast Anesthesiology Consultants, P.A.
Minimal Sedation
? Does not mandate implementation of Conscious Sedation Policy
? Patient maintains ? Normal respiration ? Normal eye movement ? Normal response to command, and ? Normal or baseline mental orientation
Copyright ? 2005 Southeast Anesthesiology Consultants, P.A.
Moderate Sedation
? Protective reflexes are intact ? Airway remains patent ? Spontaneous ventilation is adequate ? Patient responds to physical
stimulation or verbal command
? No adverse effect on cardiorespiratory function
Copyright ? 2005 Southeast Anesthesiology Consultants, P.A.
Deep Sedation
? Use of medication to induce a level of
depressed consciousness from which the patient is not easily aroused
? Can result in partial or complete loss of
protective airway reflexes
? Need for airway support
? Beyond the scope of this policy
Copyright ? 2005 Southeast Anesthesiology Consultants, P.A.
Pre-Operative Evaluation of Cardiopulmonary Diseases
? Patients with moderate to severe heart or lung disease will have decreased ability to tolerate deviations from normal levels of consciousness
? They can easily decompensate during mild hypoxia or hypercarbia
? Consider Anesthesiology consult for such patients
Copyright ? 2005 Southeast Anesthesiology Consultants, P.A.
American Society of Anesthesiologists Classification
? ASA 1 : No health problems. ? ASA 2 : Mild to moderate systemic disease ? ASA 3 : Severe systemic disease ? ASA 4: Severe systemic disease that is a
constant threat to life ? ASA 5: Moribund patient not expected to
survive without procedure
Copyright ? 2005 Southeast Anesthesiology Consultants, P.A.
Airway Assessment
? Mallampati class ? Difficult airway anatomy ? History of difficult intubation ? Disease states associated with a
difficult airway
Copyright ? 2005 Southeast Anesthesiology Consultants, P.A.
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