clinical indicators - Australian and New Zealand College of ...

Intravenous anaesthetic agents such as propofol must only be used by asecond medical practitioner trained in their use because of the risk ofunintentional loss of consciousness. These agents must not be administeredby the proceduralist.10. DOCUMENTATIONThe clinical record should include the names of staff performing sedation and/oranalgesia, with documentation of the history, examination and investigationfindings. A written record of the dosages of drugs and the timing of theiradministration must be kept as a part of the patient's records. Such entries shouldbe made as near the time of administration of the drugs as possible. This recordshould also note the regular readings from the monitored variables, includingthose in the recovery phase, and should contain other information as indicated inthe College Professional Document PS6 Recommendations on the Recording ofan Episode of Anaesthesia Care.11. RECOVERY AND DISCHARGE11.1 Recovery should take place under appropriate supervision in a properlyequipped and staffed area (see College Professional Document PS4Recommendations for the Post-Anaesthesia Recovery Room).11.2 Adequate staffing and facilities must be available in the recovery area formanaging patients who have become unconscious or who have sufferedcomplications during the procedure.11.3 Discharge of the patient should be authorised by the practitioner whoadministered the drugs, or another appropriately qualified practitioner. Thepatient should be discharged into the care of a responsible adult to whomwritten instructions should be given, including advice about eating anddrinking, pain relief, and resumption of normal activities, as well as aboutmaking legally-binding decisions, driving, or operating machinery.11.4 A system should be in place to enable safe transfer of the patient toappropriate medical care should the need arise.12. TRAINING IN PROCEDURAL SEDATION AND/OR ANALGESIA FORNON-ANAESTHETIST MEDICAL PRACTITIONERSIt is recommended that non-anaesthetist medical practitioners wishing to provideprocedural sedation/analgesia should have received a minimum of 3 months fulltime equivalent supervised training in procedural sedation and/or analgesia andanaesthesia. They should participate in a process of In-Training and CompetencyAssessment. Training should include completion of a crisis resourcemanagement simulation centre course.It is recognised that there will be non-anaesthetist medical practitioners whohave had many years experience in procedural sedation and/or analgesia, butwho may not have had a period of formal supervised training as described. Such7