Moderate Sedation

Airway

100

This is characterized by increased work of breathing

What is respiratory depression

200

After your patient receives versed and fentanyl for a cardioversion ,your patient's colour changes to pale and dusky and you notice use of accesory muscles and retractions. What are you to do now?

What is open airway and reposition head , provide supplemental O2, consider reversal agents, use bag mask ventilation if necessary

300

A forceful, involuntary spasm of the laryngeal musculature caused by stimulation of the superior laryngeal nerve. This is seen more commonly in children and geriatrics and occurs at light levels of sedation.

What is laryngospasm

400

Laryngospasm is the most common significant complication of procedural sedation and the top two treatments of this are;

What is employing the laryngospasm maneuver, positive pressure ventilation using 100% O2 with a tight fitting mask and if spasm persists and hypoxia develops, administering succinycholine in order to paralyze the laryngeal muscle and allow controlled ventilation.

500

This monitors the status of ventilation and will show you the earliest indicator of airway or respiratory compromise

What is capnography

Drugs

100

This drug's class is a sedative. Action is amnesia and hypnotic Onset is 1-5 minutes Duration is 15-20 minutes Side Effect depresses subcortical levels of CNS, sexual arousal,apnea, and potential for deep sedation.

What is Midazolam (Versed)

200

Class: Opiod Action: Analgesia (no sedation) Contraindications: Increased ICP and those with severe respiratory disease and depression Side Effects: Hypoxia, apnea, hypotension, bradycardia, N&V, pruritis Clinical Cautions: 100x more potent than morphine Rapid Onset;lasts 30-60 minutes Rapid bolus may lead to chest wall rigidity.

What is Fentanyl

300

Class: Sedative Action: Anesthesia Contraindications: Head trauma (decreases ICP) Hypotension Allergy to soy or eggs Side Effects: Apnea, hypoventilation, hypotension Clinical Cautions: Only those trained in general anesthesia may give, rapid onset, will be apneic

What is Propofol

400

Class: Hypnotic Action: Anesthesia, amnesia (no analgesia) Contraindications: Addison's disease,children < 10 years (higher risk of adrenal suppression), children in shock Side effects: Myoclonus,pain with injection, N&V Clinical Cautions: Rapid onset;lasts 3-5 minutes

What is Etomidate

500

This term refers to what happens when you administer medications so close together that the peak effect of each dose coincide. This practice can result in an excessive total drug effect over time.

What is Dose Stacking

Sedation

100

This is a drug-induced state during which the child/adult respond normally to verbal commands. Cognitive function and cordination may be impaired, ventilatory and cardiovascular vunctions are unaffected.

What is Minimal Sedation

200

A drug-induced depression of consciousness during which sedatives or combination of sedatives and analgesic medications are often used and may be titrated to effect.

What is Moderate Sedation

300

A trancelike cataleptic state occurs with both profound analgesia and amnesia while maintaining protective airway reflexes, spontaneous respirations, and cardiopulmonary stability

What is Dissociative Sedation

400

A drug-induced depression of consciousness during which patients cannot be easily aroused, but respond purposefully following repeated or painful stimulation. Independant ventilation may be impaired but cardiovascular function is usually maintained.

What is Deep Sedation

500

Name the FIVE goals of effective sedation

What are: Protect patient's safety Minimize discomfort and pain Control anxiety, psychological trauma Control behaviour Return patient to a state safe for discharge.

Policy

100

This type of sedation for diagnostic or a therapeutic procedure is used if the order is written as a one time dose,if a child is age 1-13 and a low risk, and if one of the only acceptable medications are given ; Lorazapam 0.05mg/kg (max 15mg) or Midazolam 0.02-0.5 mg/kg (max 15 mg) or Valium 0.1-0.2 mg/kg (max 10mg)

What is Pediatric Minimal Sedation

200

Name the equipment needed at bedside for moderate sedation.

What is crash cart, O2, sx, monitor, and appropriate reversals.

300

The Procedure/Site Verification Checklist for Procedures Outside the OR (TIME OUT) documents the following: Right Patient Right site and site is marked and

What is- agreement with the team (and patient) of the procedure to be done and accurate procedure consent form has been signed.

400

This physical classification status must be determined by the provider prior to moderate sedation. It includes V classes

What is ASA Physical Status Classification

500

You have just finished the procedure and your patient is arousable on calling only , his saturation is 94 % on room air,he is able to move all 4 of his extremities upon command, he is able to breathe deeply and cough on command, and his BP is as it was pre anesthetic. What is his aldrete score?

What is 9

Potpourri

100

This kit contains agents to be used prior to intubation. It is kept in the medication room refrigerated and the form needs to have the correct patient label.

What is the RSI kit

200

This is a two part answer: We have two monitors that have this added capability and live in this room. Microstream cannulas are stored in this room.

What is Room 1 and 2 What is in the equipment room, wire wrack , 2nd shelf closest to door

300

Written and verbal discharge instructions include 10 items that include side effects, duration of sedation, medication regime , diet, activity, and

What is pain management, follow-up care, skills for self care, emergency contact information, signs and symptoms of potential complications to watch for and report.

400

Our discharge instructions specify that the patient be advised to not do ..

What is: drive an automobile (they must have a ride home), participate in activites that need normal reflexes and coordination, and they should not sign legal documents until the next day

500

This is a benzodiazepine receptor antagonist which you give 0.2 mg IV over 30 seconds. If after 30 seconds consciousness is not obtained a dose of 0.3mg IV may be given. Your total maximum dose is 3mg/hour

What is Flumazenil (Romazicon)