Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Upcoming SlideShare
What to Upload to SlideShare
Next
Download to read offline and view in fullscreen.

Share

Sedation

Download to read offline

Hassan Mohamed Ali
Associate professor of anesthesia and pain management, Anesthesia department, Cairo University.
MB.B.ch, M Sc, M.D, FCAI, DESA
Meeqat General Hospital, Madinah Munawarah

Related Audiobooks

Free with a 30 day trial from Scribd

See all
  • Be the first to like this

Sedation

  1. 1. Hassan Mohamed Ali Associate professor of anesthesia and pain management, Anesthesia department, Cairo University. MB.B.ch, M Sc, M.D, FCAI, DESA Meeqat General Hospital, Madinah Munawarah
  2. 2.  Definition :  The use of medications to minimally depress the level of consciousness in a patient while allowing the patient to continually and independently maintain a patent airway and respond to verbal commands and/or gentle stimulation.
  3. 3.  1-glasgow coma scale  2-The Ramsay scale  3-Modified Ramsay Sedation Scale  4-University of Michigan Sedation Scale (UMSS)  5-. The Dartmouth Operative Conditions Scale (DOCS)
  4. 4. Score Characteristics 0 Awake and alert 1 Minimally sedated: tired/sleepy, appropriate response to verbal conversation and/or sound 2 Moderately sedated: somnolent/sleeping, easily aroused with light tactile stimulation or a simple verbal command 3 Deeply sedated: deep sleep, arousable only with significant physical stimulation 4 Unarousable
  5. 5.  It is used for a variety of diagnostic and surgical procedures especially:  endoscopy  closed reduction of fracture  radiologic procedures
  6. 6.  Reassurance  Explanation  Drugs:  Benzodiazepines (Midazolam,lorazepam,diazepam)  Narcotics (Pethidine,fentanyl,morphine…etc)  Hypnotics (Chloral hydrate,propofol, Barbiturates)  Dexmedetomidine (precedex)  ketamine
  7. 7.  Midazolam:  Dose: 1 to 2.5 mg slow IV every 2 minutes  Antidote: Flumazenil (Anexate)  Fentanyl  Dose:1g.kg-1  Antidote: Naloxone (Narcain)   N.B. :I.V, weight
  8. 8.  Environment: • crush trolley • airway equipment • full monitoring • alarming system • Patient: • consent • History • Examination: airway, vitals
  9. 9.  Equipment and monitoring:  oxygen supply  suction apparatus and catheter  airway equipment's  face mask  oral or nasopharyngeal airways  LMA  resuscitation bag  endotracheal tubes  laryngoscopes  resuscitative equipment and medications (crash cart)
  10. 10.  Doctor or nurse beside the procedure all the times  O2 saturation  Vital signs checked (BP, pulse, respiratory)  Documentation
  11. 11.  Failure  Pain  Over sedation(delayed recovery)  Airway obstruction  Vomiting  Hypotension  Arrhythmia  hypoxia
  12. 12.  ACLS  ER  ICU  Anesthesia  WELL TRAINED PERSONNEL  Follow the policy
  13. 13.  Appropriate alertness (brain)  Appropriate vital signs (heart)  Oxygen saturation above 92%on room air(lung)  Ambulation (if he/she ambulated before)(limbs)  No nausea or vomiting (stomach)
  14. 14.

Hassan Mohamed Ali Associate professor of anesthesia and pain management, Anesthesia department, Cairo University. MB.B.ch, M Sc, M.D, FCAI, DESA Meeqat General Hospital, Madinah Munawarah

Views

Total views

413

On Slideshare

0

From embeds

0

Number of embeds

0

Actions

Downloads

2

Shares

0

Comments

0

Likes

0

×