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Conscious Sedation

  • Docement pre-procedure H&P, assessment, ASA classification, patient consent
  • Check that crash cart, O2, SPO2 reading equipement, Mask/bag are immediately available.
  • Continually monitor pulse ox, mental status, blood pressure

Reversal Drugs

Drugs Initial Dose Total Dose
Flumazenil; Romazicon (Benzo reversal) 0.2mg over 15 sec IV, wait 45 sec, then may repeat 0.2mg q 1min x 4. Peds: 0.01mg/kg. 1mg (10ml)/5min, 3mg in 1 hours
Naloxone(Narcan) 0.1-0.2mg q2min IV; 0.2mg repeat q1-2hours prn: peds=0.005-0.01 IV/IM/SQ/ET  

Sedation Drugs

Fentanyl 50-100mcg slow IV over 1-2 minutes (1-2mcg/kg); titrate to effect 300 mg in 1 hour
Midazolam (Versed) 1-2mg slow IVP 5mg in 1 hour
Ketamine (Ketalar) 1-2mg/kg IV over 1-2 min: consider concurrent atropine to minimize hypersalvation.  

ASA Classification

ASA Physical Status
1 Normal healthy patient
2 Mild to moderate systemic disease with no funtional limitations
3 Severe systemic disease with functional limitations
4 Severe systemic disease that is a constant threat to life
5 Moribund patient not expected to survive with or without the intervention