Please familiarize yourself with the DRH Health Moderate Sedation policy and procedure found here

A pre-sedation assessment by the physician is required to be documented prior to sedation. This includes:

  • H&P/ED Record, including ROS, VS, airway assessment (Mallampati), cardiopulmonary status;
  • Plan for sedation;
  • ASA risk classification (ASA risk scored III or IV – consider sedation by CRNA).

Documentation of informed consent for sedation is required.

Moderate sedation should be performed only by providers with approved moderate sedation privileges.

In the Emergency Department Ketamine, Propofol, and Etomidate may be administered by physicians with moderate sedation privileges who are trained and available to manage complications should they arise

Patients are monitored for a minimum of 30 minutes following the last dose of medication when no reversal agent is used. Patients are monitored for a minimum of 60 minutes when a reversal agent is used.

When discharge occurs following moderate sedation, discharge instructions specific to the use of moderate sedation are provided to the patient in addition to any other instructions specific to the patient’s condition(s).

Moderate Sedation Test and Attestation

The medication of choice to reverse the effects of benzodiazepines is:
Mrs. Brown is a 55 y.o. female admitted to ACU for a colonoscopy to diagnose lower GI bleeding. Her history is unremarkable and she has no allergies. As the physician, you order Meperidine and Versed for the medications. What is the most common ill-side effect to observe for in this patient receiving sedation?
Which parameters should be monitored at least every 5 min during a procedure while using moderate sedation meds?
Which of the following drugs are opioids?
The risk associated with use of a reversal agent is that the opioid effect may outlast the half-life of the reversal agent and the patient is at risk for re-sedation later in the course of recovery time.
An 89 year old patient who is aphasic and combative needs to be sedated to insert a central line. What item(s) on the patient's history are important to know prior to administering moderate sedation?
The medication of choice to reverse the effects of opioids is:
Moderate sedation is defined as a medication-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light stimulation.
The usual dose range of Versed for use in moderate sedation is:
A specific risk in using Ketamine, especially in children, is increased salivary and bronchial secretions which may cause upper airway obstruction and laryngospasm.

I attest to having read the DRH Health Moderate Sedation Policy and Information and have completed the Moderate Sedation Test. If I score less than 80% on the test, I understand I will be contacted by the Medical Staff Services Department to re-test.

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