Conscious Sedation can be an appropriate way to provide comfort to a patient during certain procedures. Doing it safely means that you implement processes and policies to protect your patients.
Bottom line is, despite how much or what type of sedation you are providing,
If you’re sedating your patients, despite how little, the rules apply.
Here is a quick reminder, based on AAAHC and CMS guidelines:
- The patient always has a patent airway, otherwise it isn’t conscious sedation.
- Your plan is approved by your Governing Board, and your physicians that directly supervise are credentialed to do so. Your policies support your plan.
- Your staff is supervised, and is qualified to administer. BLS and ACLS is current, competency tested and understand Safe Injection Practices(and you have a policy that details these practices).
- You establish what medications you will use, and what are safe limits. Make sure you have the appropriate reversal agents available.
- You have emergency supplies and equipment immediately available. Don’t forget about the need to monitor CO2 if your patient is more deeply sedated than intended, and having regular drills with evaluation of the staff’s response to their use of the equipment…..
and as my favorite first charge nurse always said…Don’t forget Mr. Suction!
- Your equipment (including Mr. Suction :-))is regularly checked, and you have emergency power back up for the equipment. If you are in a facility that doesn’t utilize a generator, that means regularly checked batteries for all emergency equipment.
- You monitor all vitals signs continuously, and you document regularly.
- Your patients are assessed to verify they are safe for discharge, and have a signed discharge order.
- Your patients go home with a responsible adult after being appropriately educated.
If you provide conscious sedation, take a minute to review that your processes are solid. You’ll sleep better knowing your patients are resting safely.
To review the AAAHC standards, visit www.aaahc.org. or email firstname.lastname@example.org.
for CMS, go to http://www.cms.gov.
Author: Leslie Mattson