Basic requirements for monitoring sedated patients: blood pressure, pulse oximetry, and EKG.
The American Society of Anesthesiologists published monitoring requirements for non-anesthesia providers performing sedation and analgesia in 2002. This manuscript covered not only the monitoring of patients under sedation and analgesia but pre-procedure evaluation and preparation, personnel availability and training, emergency equipment availability, use of supplemental oxygen, sedative-analgesic agents, and discharge criteria. Current recommendations for monitoring include patient responsiveness, blood pressure, respiratory rate, heart rate, and oxygen saturation. Oxygen saturation is a critical vital sign, but there can be a significant delay between inadequate ventilation and desaturation. Supplemental oxygen can dangerously increase this disconnect. Thus, one must monitor adequacy of ventilation by direct observation, auscultation, and/or end-tidal CO(2) monitoring. The most important admonition is that 'ventilation' and 'oxygenation' are not the same.
Maurer
Walter G
WG
Ambulatory Anesthesia, Department of Anesthesia, Anesthesia Institute, Cleveland Clinic, Cleveland, Ohio, USA. MAURERW@ccf.org
Walsh
Michael
M
Viazis
Nikos
N
D000698:Analgesia / Q000009:adverse effects / Q000379:methods*; D001794:Blood Pressure; D004562:Electrocardiography; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D012119:Respiration; D056152:Respiratory Rate
D010100:Oxygen