Clinical monitoring in sedation Flashcards
(33 cards)
Why do we need to monitor in sedation
- To check depth of sedation
- To check for adverse reactions to the drug or treatment
- To detect respiratory problems
- To detect cardiac problems
- Medicolegal reasons
What can we monitor
- Appearance
- Conscious level
- Airway
- Breathing
- Circulation
- Oxygen saturation
- Blood pressure
What is monitoring split into
- Clinical signs
- Electromechanical
How many people do we need to perform treatment under sedation
3
Operator
Assistant
Someone to monitor stats and patient
What do we look at appearance wise when assessing a sedated patient
- Less muscle tone and slower movements but still lightly alert
- Pt may close eyes but this can be a sign of over sedation
- Soft tissue colour eg cyanosis
- Check skin for rashes or allergic reactions
How do we assess conscious level and behaviour
Prompt responses to verbal suggestions at lighter sedation level
What can happen if a patietn is over sedated
May fall unconscious or be unco-operative
How do we assess a patients airway during sedation treatment
- Listen to the clarity of airway
- Look for potential obstructions and remove them
What is surpassed during sedation
Gag reflex
Having a suppressed gag reflex means what
If the airway is obstructed patietn will no cough it out so assistant needs to be vigilant an monitoring patient
How do we assess a patients breathing during sedation treatment
- Assess movements of the chest and abdomen
- Are the breaths deeps or shallow
- Check respiratory rate
State a normal resproatoqty rate
12-15bpm
How do we assess a patients circulation during sedation treatment
- Pulse rate
- Pulse character
- Pulse regularity
How can we assess the pulse of a sedated patietn mid treatment
Use pulse oximeter
What does a pulse oximeter measure
Oxygen saturation
What is oxygen saturation
The percentage of haemoglobin saturated with oxygen
The levels of what in our blood drives respiration ?
Blood CO2
What happens as blood CO2 increases?
Respiration increases to get rid of the CO2
What does haemoglobin do
It releases oxygen into the tissues
Why do we want the oxygen saturation to be high
- Oxygen dissociation curve
2.
What does the oxygen dissociation curve show us
That as one molecule of oxygen is lost it is easier to lose all the oxygen molecules
What can cause the oxygen dissociation to shift to the right (right shift)
- Low pH
- High CO2
- High temp
What does a right shift in the oxygen dissociation curve mean?
less oxygen take up in the lungs more available in the tissues
What can cause the oxygen dissociation to shift to the left (left shift)
- high pH
- low CO2
- low temp
