Procedural Sedation Administered by Non-Anesthesiologist Providers

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PROCEDURAL SEDATION ADMINISTERED BYNON-ANESTHESIOLOGIST PROVIDERSADDENDA ASEDATION SCALES IN USE IN THE REGIONLevel of Sedation (LOS)1 Awake and alert2 Awake but sleepy3 Asleep, easily arouses4 Asleep, not easily arousable5 Asleep, not arousableUsed at SMCSRamsey Sedation ScaleUsed at SRMC1 Patient awake, anxious and agitated; or both2 Patient awake, cooperative, oriented, and tranquil.3 Patient awake but drowsy, sleepy, tranquil, responds toverbal commands only. Eyes may be closed butresponds to commands without tactile stimulation.Patient will still be able to answer questions about painor discomfort to determine need for analgesia.4 Patient asleep but briskly responds to loud auditorystimulus gently shaking or light glabellar tap (light tapbetween the eyes). Drifts back to sleep duringconversation.5 Patient asleep and responds only to noxious stimuli orhas sluggish response to loud auditory stimulus or lightglabellar tap (light tap between the eyes).6 Patient asleep and has no response to firm nail bedpressure or other noxious stimuli.Richmond Agitation Sedation Scale (RASS) Used at SDHTarget RASS Description+4 Combative, violent, danger to staff+3 Pulls or removes tube(s) or catheters, aggressive+2 Frequent non-purposeful movement, fights ventilator+1 Anxious, apprehensive, but not aggressive0 Alert and calm-1 Awakens to voice (eye opening/contact) > 10 seconds-2 Light sedation, briefly awakens to voice (eyeopening/contact) < 10 seconds-3 Moderate sedation, movement or eye opening???, noeye contact-4 Deep sedation, no response to voice, but movement oreye opening to physical stimulation-5 Unarousable, no response to voice or physicalstimulationI:ProceduralSedationNonAnesthProviders.doc (April 2012)
PROCEDURAL SEDATION ADMINISTERED BYNON-ANESTHESIOLOGIST PROVIDERSSAFH – Sutter Auburn Faith Hospital• Special Procedures/OR/PACU• ICU/CCU/TCU• Emergency Department• Diagnostic Imaging Services• Cardiac Cath Lab• Cardiopulmonary ServicesADDENDA BLOCATIONS WHERE SEDATION MAY BE ADMINISTEREDSDH – Sutter Davis Hospital• Special Procedures/Bronchoscopy Procedure Room• Critical Care Nursing Units• Emergency Department• Endoscopy Room• Diagnostic Imaging (ED patients only/monitored by ED staff)SMCS – Sutter Medical Center Sacramento• –Procedural sedation can be provided in clinical locations where all requirements of this patientcare standard can be met.SRMC – Sutter Roseville Medical Center• Special Procedures and Bronchoscopy Procedure Room• Telemetry and Critical Care Units• Emergency Departments• Diagnostic Imaging Services• Outpatient Services• Operating Room, Post Anesthesia Care Unit, Surgical Preparation Area (SPA)• Endoscopy Laboratory• Angiography and Cardiac Catheterization LaboratorySSMC – Sutter Solano Medical Center• Surgical Services• Endoscopy• PACU• ICU• ED• RadiologyI:ProceduralSedationNonAnesthProviders.doc (April 2012)
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Procedural Sedation Administered by Non-Anesthesiologist Providers

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