Sedation Quiz - Key Concepts

Sedation Quiz - Key Concepts

• Adverse Events of Ketamine Sedation (Emergency Settings):

  • Most common adverse event is respiratory depression.
  • Other potential adverse events include hypotension, laryngospasm, and allergic reactions.

• Risk Factors for Difficult Airway Management in Pediatric Sedation:

  • Obesity is a primary risk factor.
  • Prior surgeries, high anxiety levels, and Mallampati Class I are also considered risk factors.

• Predicting Difficult Airway Before Sedation:

  • Reviewing patient history is the most effective method.
  • CT imaging or randomized trials are less effective for this.
  • Assessing patient history offers the best prediction.

• Managing Laryngospasm During Ketamine Sedation:

  • Administering epinephrine is a critical step.
  • Providing positive pressure ventilation is another effective method.
  • Increasing ketamine dose may be helpful in some instances, but this is not typical treatment.
  • Performing immediate tracheostomy is extreme and unlikely to address the issue.

• Monitoring Device for Hypoventilation During Moderate Sedation:

  • Capnography is essential for detecting early hypoventilation.
  • Other devices, such as pulse oximeters, ECGs and non-invasive blood pressure monitors, do not solely evaluate the ventilation aspects of sedation.

Monitoring Children After Sedation

• Minimum Monitoring Time After Sedation (Children):
  • Monitor until the child regains full consciousness.
  • 15 minutes after the procedure is a good minimum duration for monitoring.
  • 30 minutes (regardless of sedation depth) is also important for monitoring.

Pulse Oximetry During Pediatric Sedation

• Accuracy of Pulse Oximetry:
  • Pulse oximetry detects hypoxia before adverse effects often become apparent.
  • Early hypoventilation will show up as a result of changes to respiration.
  • Capnography can be used to help supplement pulse oximetry.

Treating Apnea During Sedation Due to Obstruction

• First-Line Treatment for Apnea:
  • Providing positive pressure ventilation is the primary treatment.
  • Administering a reversal agent or increasing the sedative dose are not first-line treatments.

Managing Bradycardia During Sedation

• Action for Persistent Bradycardia:
  • Administering atropine directly counteracts bradycardia.
  • Increasing sedation is not the right approach if bradycardia appears.

Treating Midazolam Overdose

• Treatment for Midazolam Overdose:
  • Administering flumazenil is a common treatment for midazolam overdose.
  • Oxygen is important for any patient with an overdose.
  • Naloxone may also play a role depending on the patient.

Pre-Sedation Fasting Guidelines (Pediatric Patients)

• Purpose of Fasting:
  • Pre-sedation fasting guidelines are primarily intended to prevent pulmonary aspiration.
  • Enhancing the efficacy of sedation medications, reducing anxiety, and prolonging sedation are not the primary reasons.

Nitrous Oxide Sedation Oxygen Concentration

• Minimum Oxygen Concentration:
  • 30% concentration of oxygen is required, at a minimum.
  • 20% is not sufficient.

This quiz covers essential concepts in sedation, focusing on ketamine's adverse events, risk factors for difficult airway management, and strategies for managing laryngospasm during procedures. Test your knowledge on these critical aspects to ensure patient safety during sedation.