Case Study Of Procedural Sedation

The aim of this case study is to analyse and evaluate the anaesthetic and recovery care delivered to a patient undergoing an Adenotonsillectomy. To do this I will outline the process of ensuring the provision of safe and effective care for the patient, give a description of the procedure and equipment used in the anaesthetic room including the drugs used for this particular case and rationale for their use. I will also give a brief description of the surgical procedure including the anaesthetic and recovery care provided. Finally, I will summarise with an evaluation of the care that the patient received. For the purpose of this study, the patient will be referred to as ”the patient”. In doing so, the patients’ right to confidentiality will not be breached and it is also within the boundaries and guidelines set out in local trust policies G10, the Health and Care Professions Council Code of Conduct & Ethics for Students (HCPC 2012 pg 9), the Data Protection Act (1998) & the Caldecott Principles (2013).

Anesthesiologists give patients anesthetics in a variety of ways, such as “orally, intravenously, by gas or direct injection to render patients insensible to pain Anesthesiologists typically maintain the same daily schedule a surgeon follows, participating in both scheduled and unscheduled operations. Anesthesiologists are responsible for determining the proper anesthetic and dosage level for each patient. They monitor the patients progress prior to, during, and after surgery.”(“Anesthesiologist” 31)

Original research related to sedation management occurred in the year 2000 by Kress, Pohlman, O ' Connor, and Hall. Their findings served as a landmark study and initiated the impetus related to improving our sedation practices. According to Kress et al. (2000), daily interruption of sedation led to a decrease in the number of days on the ventilator in the intensive care unit. Several studies since this time have focused on the influence of sedation protocols, and outcomes. This paper will review the synthesis of the discovered studies and highlight the noted contraindications and inconsistencies. Also, explanations including a preliminary conclusion will be discussed.

This Anaesthetic case study would describes and discussed the scenario of a patient through the anaesthetic role of their surgical procedure. It will include and discuss the anaesthetic safety procedures equipment and drug interventions used to ensure this particular patients maximum safety and comfort before and during the procedure. The case study will include pre and peri-operative assessment in order to describe the involvement contribution of various specialties in the holistic care of the critical care patient. This assignment will focus only on the anaesthetics side of the procedure but will also highlight the importance of the triad of anaesthesia and discuss the administration, maintenance and reversal of

On arrival to UKMC the patient received a Glasgow Coma Score of 3, which is an indication that intubation is needed. Bipap therapy was attempted but failed, due to respiratory failure. This was confirmed by arterial blood gases. After being assessed by the team at UKMC, the patient was intubated for respiratory failure, as well as shock of an unclear etiology. Rapid sequence intubation drugs, Etomidate and Succinylcholine where administered prior to intubation. A 7.5 endotracheal tube was used

As with every other form of medical procedure, sedation dentistry should only be administrated by experienced and trained professionals. Dr. Booth, as well as the rest of the staff at The Tooth Booth Family Dental Clinic, are dedicated to providing their patients with the latest advances in dental care, including remaining current on effective sedation methods. With a Doctorate in Dental Surgery, Dr. Booth has extensive experience with providing sedation options for his patients.

This task will analyze a given patient scenario with a poor outcome and a root cause analysis will determine the causative factors that led to the event, a plan for improvement will de proposed, and analysis of the likelihood the improvements will be successful will be recommended.

Death is one of the most significant life events people experience. Most people want to die a peaceful death and desire the same outcome for their family and friends. Medical advancements have resulted in people living longer lives with chronic illnesses. Despite the advancements in medicine and the available treatments of today, sometimes the patient is still unable to escape intolerable suffering; the patient’s quality of life diminishes.

Many factors have contributed to the sentinel event, specifically the current conscious sedation policy. The improvement plan would include revising the conscious sedation policy to ensure the patient is properly monitored post procedure and to intervene when issues arise. The sedated patient should be monitored one on one post procedure by an RN, who is educated on the conscious sedation protocol, for thirty minutes or until the patient reaches his baseline. Also, mandatory monitoring will include EKG, pulse oximetry, blood pressure, heart rate, respirations and level of consciousness. A list of appropriate medications and the dosages should be included in the conscious sedation policy. In addition, reversal agents should be readily

Trauma patients often present paramedics with difficult situations to handle. These patients most likely have multiple injuries that the paramedic must treat including internal and external injuries. The main concern in treating trauma patients is controlling the pain that the patient may be experiencing while not compromising the patients hemodynamic and respiratory state. The most common drugs used in pain management in the pre-hospital setting often cause undesirable side effects, such as respiratory depression, hypotension, apnea, and bradycardia. All of these side effects combined with a trauma patient who is already compromised can lead to a much bigger issue. What if there was a drug that could treat the pain, calm the patient, and not cause the nasty side effects of traditional pain management? Ketamine provides us the answer to this question.

Ketamine can be used for sedation before minor procedures, although this use is not approved by the FDA

An open skull fracture consists of a break of the dura that expose the cranial contents to the environment. Some of the complications that should be considered are posttraumatic seizures, infection (e.g. meningitis), blood clot, cranial nerve damage, and leaking of spinal fluid. Posttraumatic seizures occur more often among open brain injuries because causal mechanisms are poorly understood. There are many changes happening in cellular and molecular level in association with injury and repair like sprouting of new neurons with hyperexcitability and lowering in GABAergic inhibiton that leads to epileptogenesis. In term of infection, bacteria or virus can cause major infection if the wound is not kept clean and it’s important to use the correct

Mr. B.’s procedure after sedation (was accomplished) was successful and his sedation level continues. Nurse J then applies an automatic blood pressure machine to measure every 5 minutes and a pulse oximeter, however the nurse does not apply any respiratory monitor or heart monitor which are protocol after a sedation procedure. The nurse then rushes out of the room leaving Mr. B. with his son with no medical personnel at the bedside to monitor the patient. No sedation score or neurological assessment of Mr. B. is noted, which should be performed after any procedure including sedation. This data is either missing, not documented or not performed by Nurse J. Mr. B.’s alarm for low saturation is alarming and the LPN enters the room briefly,

In regards to non-accidental injuries, abusive head trauma is the most common source of fatality and long-term morbidity. Ninety-five percent of serious central nervous system (CNS) injuries arising in infants younger than 1 year are a result of abusive head trauma (Flaherty, Perez-Rossello, Levine, & Hennrikus, 2014). CT is the modality of choice used in the initial diagnosis of a child with suspected head trauma as it is readily available in most emergency departments. Also, a CT scan takes fewer than five minutes to complete. It is advised that a cranial CT without contrast should be performed as soon as possible following admission. According to the ACR sanctions, protocol required for neuroimaging depends on the child’s age and clinical presentation. The radiologic technologist should adjust the settings according to the age of the child to reduce radiation exposure. CT scans should be performed with soft-tissue algorithm reconstructions using a slice thickness of 5 mm, and with bone algorithm reconstructions, a slice thickness of 2.5 mm syndrome (Flaherty, Perez-Rossello, Levine, & Hennrikus, 2014). Computed Tomography is very precise in detecting skull fractures and hematomas. Non-accidental skull fractures may be classified as linear, complex, depressed, or diastatic. The parietal bone and occipital bone are the most commonly fractured in cases of

Anesthesia is the loss of feeling or sensation. It may be accomplished without the loss of consciousness, or with partial or total loss of consciousness. Anesthesia has not been around forever, but there is a background history of its creation and the primitive anesthetics used before anesthesia was discovered. Today there are many different anesthetics and delivery methods dependent to the type of procedure. Anesthesiologists and nurse anesthetists are a crucial part of the surgical team. Without anesthesia where would we be today?