General Approach to All Patients

Sedation / Sedative Agent Use

It is not always possible to predict how patients will respond to receiving a sedative medication. This protocol is to be used in conjunction with any protocol that involves the use of medication which may result in sedation. Authorized medications that may result in sedation are Fentanyl, Midazolam/Diazepam, Ziprasidone, and Diphenhydramine.

Minimal sedation

A drug induced state in which patients respond normally to verbal commands. Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are unaffected.

Moderate sedation

A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. Airway patency, spontaneous ventilations, gag reflex and cardiovascular function are maintained.

Deep sedation

A drug induced depression of consciousness, during which patients cannot be easily aroused but respond purposefully after repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway and spontaneous ventilations may be inadequate.

Sedative agent use should ideally result in minimal or moderate sedation only.

Advanced Life Support

  • Continuously monitor the following:
    • Patency of airway
    • Vital signs
    • Oxygen saturation and capnography
    • Cardiac rhythm
    • Level of consciousness and ability to follow commands
  • Assure that appropriate equipment and personnel are immediately available for care and resuscitation if problems arise
  • Document of the indications for sedation