Sedation and the Anesthesia Continuum

#1 - Nurses and Sedation

I. Historical Perspectives and the Future

II. RN Practice Control

Board of Registered Nursing
Professional Organizations
Accrediting Bodies
Facility Policies and Procedures

III. Pushing the Envelope – Advantages and Concerns

IV. Legal Concerns

Negligence Law
Consent Law
Liability Prevention

V. Defining the Role of Nurses in Sedation

Competence Statement Development and Implementation

Behavioral/Learning Objectives:

1. Describe the societal changes in health care delivery that have led to greater utilization of registered nurses to provide procedural sedation.
2. Outline the criteria set by many Boards of Registered Nursing for nurses to perform sedation for procedures.
3. Explain the impact of accrediting agencies on the utilization of nurses to provide procedural sedation.
4. State at least two legal concerns for nurses providing procedural sedation.
5. Write a sample competence statement for nurses providing procedural sedation.
   

#2 - Physical Assessment and Monitoring

I. Patient counseling and Informed consent

II. Physical Assessment

A. Health status evaluation
B. Fasting Status
C. ASA (PS) Classification

III. Essential Monitors

IV. The Physiology of Oxygenation

V. Assessing the Level of Consciousness

VI. Advanced Monitoring Modalities

A. Capnography
B. Bispectral Analysis

Behavioral/Learning Objectives:

1. Describe the required components of Informed Consent for Sedation.
2. List the components of appropriate health status assessment of adult patients prior to sedation.
3. Discuss which monitors are essential for use during procedural sedation.
4. Outline the basic concepts of consciousness assessment utilizing scales or monitors.
   

#3 - Sedating Children

I. Goals for sedation

II. Pediatric Assessment

III. Techniques and Monitoring Criteria

IV. Adverse Events and Outcomes

V. When to say “no”

Behavioral/Learning Objectives:

1. List the goals of sedation for children.
2. List the components of appropriate health status assessment of infants and children prior to sedation.
3. Discuss which monitors are essential for use during procedural sedation of children/infants.
4. Outline the basic concepts of consciousness assessment in children/infants utilizing scales or monitors.
5. Discuss the limits of the RN role in the sedation of Children/infants.
   

#4 - Pharmacology

I. Agents of Interest

A. Ketamine
B. Propofol (Diprivan)
C. Barbiturates and chloral hydrate
D. Narcotics- Fentanyl and Friends
E. Sedative – Midazolam and Friends

II. The Use of Local Anesthetics

III. Adjuvant Drugs

A. Glycopyrrolate/Atropine
B. Naloxone
C. Flumazenil
D. Ondansetron and friends

Behavioral/Learning Objectives:

1. Describe the mechanisms of action of common drugs used for procedural sedation.
2. Outline the reasons for use and the concerns surrounding RN administered propofol.
3. Explain the major physiological effects expected following the intravenous administration of narcotics and/or sedatives.
4. Describe the symptoms associated with local anesthetic toxicity.
5. Identify appropriate situations in which reversal agents may be necessary.
   

#5 - Technique Considerations in Sedation

I. Technique Approaches

II. Considering Type and Duration of Procedure

III. Need for Pain Relief

IV. Need for axiolysis

V. Anticipating Difficult Patients

Behavioral/Learning Objectives

1. Explain the sequence in which medications should be administered to produce desired levels of sedation and/or analgesia.
2. Define the essential concepts of appropriate titration techniques in sedation administration.
3. Describe factors that contribute to the identification of a difficult patient for procedural sedation.

#6 - Managing Complications

I. Respiratory Complications

II. Cardiovascular Complications

III. Drug Interactions

IV. Controversies – Where Should the Line be Drawn?

V. Case Studies

VI. Final Thought

Behavioral/Learning Objectives:

1. Explain the physiological and positional factors that can complicate management of the airway during sedation.
2. Describe the causes and management of bradycardia or PVC’s during procedural sedation.
3. List three drug interactions that may be of concern to RN’s during procedural sedation.
4. Identify a major controversy of concern as the nursing role in provision of procedural sedation expands.
   

Accreditation Information

Nurses – Academy Medical Systems is an approved provider of continuing nursing education by the Illinois Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. 9.0 contact hours will be rewarded to nursing professionals at the completion of this workshop.

Academy medical Systems is also a provider approved by the California Board of Registered Nursing, provider #CEP14413, for 9.0 hours. And we are also a provider approved by the Florida Board of Nursing, provider #50-19, for 9.0 hours.

Iowa Nurses - The Iowa Board of Nurses will recognize the recorded webinars as a home study program. They recognize our ANCC approved provider status as well as our CA and Fl Board of Nursing provider approval for home study products for nurses in Iowa.

All other states recognize our approved provider status listed in the above text for continuing education credit for nurses.

Learn more about Academy Medical's presenters

View details about past webinars

Already Registered: login, take post-tests or listen to a recorded webinar