Safe Sedation Procedures in Adults

Procedural Sedation

3 Topics

When is it Appropriate?

Identify At Risk Patients

4 Topics

Clinical Assessment

Pharmaceutical Agents

3 Topics

Pharmaceutical Agents

Which Agent is Most Appropriate?

Safe Sedation Practice

7 Topics

Training Requirements and Personnel

Environment, Equipment and Monitoring

Recovery and Discharge

4 Topics

Safe Sedation Procedures in Adults

Safe Sedation Procedures in Adults

Safe Sedation Procedures in Adults Safe Sedation Procedures in Adults

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Question 1 of 10

1. Question
1 point(s)
Which of the following statements regarding the principles of procedural sedation is correct?
- The aims of procedural sedation are to relieve patient pain and anxiety
- Procedural sedation is useful when clinical staff are busy and have insufficient time to manage a patient's pain and anxiety
- The aim of procedural sedation is to relieve patients' anxiety and facilitate cooperation with a painful procedure
- It is good practice to have a standard dose and method of administration of one particular sedative agent
- The aims of procedural sedation are to relieve patient pain, anxiety and induce amnesia
Question 2 of 10

2. Question
1 point(s)
Which one of the following statements defines procedural sedation?
- A state of reduced consciousness where the patient responds to a verbal stimulus
- A state of reduced consciousness where the patient responds to a verbal or light physical stimulus
- A state of reduced consciousness where the patient responds only after repeated stimulation
- A state of reduced consciousness where the patient responds only by moaning and withdrawing to a painful stimulus
Question 3 of 10

3. Question
1 point(s)
Adverse events during procedural sedation are more common in which one of the following scenarios?
- When the patient has eaten within 8 hours of the procedure
- When the analgesic and sedative agents used are morphine and midazolam
- When the patient is an alcoholic
- When the patient undergoes sedation with loss of consciousness
Question 4 of 10

4. Question
1 point(s)
Which of the following must be available during all ED procedural sedations?
- An anaesthetist
- A blood gas analyser
- A tilting trolley
- An anaesthetic machine and breathing circuit
- Results of a recent full blood count and urea and electrolytes screen
Question 5 of 10

5. Question
1 point(s)
It is 02:30 Sunday and the ED is very busy. A 24-year-old male has been brought in with an anterior dislocation of his left shoulder. He fell whilst leaving a curry house having consumed much alcohol that evening. He has vomited several times; there is no clear evidence of head injury.

All of the following are contraindications or relative contraindications to performing procedural sedation in this case except one. Can you identify the exception?
- Alcohol intoxication
- Recent ingestion of a large meal
- Lack of sufficient appropriately trained staff
- Lack of appropriate training in procedural sedation techniques
- Lack of written consent
Question 6 of 10

6. Question
1 point(s)
Which of the following is NOT a monitoring requirement during procedural sedation?
- Pulse oximetry
- Invasive blood pressure monitoring
- Non-invasive blood pressure
- Respiratory rate
- ECG
Question 7 of 10

7. Question
1 point(s)
Which of the following statements regarding airway assessment is correct?
- An edentulous, elderly patient is likely to be easy to ventilate using the bag-valve-mask system
- Recent facial trauma can make an airway more difficult to manage
- Patient obesity is unlikely to be significant
- The presence of a beard or other facial hair makes it easier to obtain a good seal with a well fitted face mask
- Assessment of the patient's neck mobility is unimportant prior to sedation
Question 8 of 10

8. Question
1 point(s)
Regarding sedative agents, which of the following statements is correct?
- Propofol is an effective analgesic agent
- Midazolam is an effective analgesic agent
- Propofol is more easily titrated to effect than midazolam
- The required dose of midazolam for an elderly patient is approximately half of that required for a young, healthy patient
- Ketamine can cause profound bronchospasm and must be used with caution in patients with asthma
Question 9 of 10

9. Question
1 point(s)
Regarding sedative agents, which of the following statements is correct?
- The total dose of midazolam for a healthy young adult should not usually exceed 5 mg
- The dose of intravenous ketamine required to produce a dissociative effect in a healthy young adult is not usually more than 0.2 mg/kg
- The cardiorespiratory effects of midazolam and propofol are not enhanced by opiate analgesia
- Nitrous oxide is best used at a concentration of 80%
- The cardiovascular effects of propofol can be avoided by injecting the calculated dose as a rapid bolus
Question 10 of 10

10. Question
1 point(s)
Which of the following statements regarding recovery and discharge after procedural sedation is correct?
- It will be safe to discharge a patient 2 hours after the last administration of sedative medication
- Recovery should take place in a quiet room away from the clinical area of the department
- It is safe to discharge a patient 15 min after receiving a reversal agent if they are alert, orientated and have regained their usual mobility with acceptable pulse, blood pressure and respiratory rate
- Vital signs should continue to be monitored for 1 hour after procedural sedation
- Patients should be provided with a post sedation advice card at discharge

8 Comments

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knottenbeltj July 12, 2017 at 8:11 am

Very good overview with lots of handy tips.

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Sylvester Rodrigues October 6, 2017 at 11:26 am

good exercise

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Simone Herrmann March 15, 2018 at 12:37 pm

Helpful exercise

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Dr. Omar Mohammed Shanas Ahmed Younus May 27, 2021 at 8:29 pm

VERY USEFUL SESSION, INDEED.

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Dr. David Palkin Ng June 9, 2021 at 12:17 pm

Useful

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Mr. Salman Ahmed Abbasi September 24, 2021 at 10:22 am

very nice

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Mr Michael Davey May 30, 2024 at 10:30 pm

very useful teaching

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Dr Divya Vinayak Markande April 5, 2025 at 1:54 am

Great and Detailed Revision.

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