Graduation Speech: Sedation-Emergency Emissions

The work of an anesthesiologist is fulfilling with many benefits. A person would desire to become an anesthesiologist because there is a high standard of excellence due to a low percentage of doctors in this special field, not to mention the high salary. This occupation benefits the doctor through a feeling of personal gratification while receiving a great education. The community benefits through his or her help relieving the pain accompanied by surgery. Becoming an anesthesiologist involves extensive education and training, while also having many requirements and a good salary range.

70 Percent of Americans do not know how to perform CPR are you one of them?

Lack of enough trained staff in conscious sedation available at the time of the procedure

This essay discusses and reflects upon patient care in the post anaesthetic care unit (PACU) and is linked to my experiences on placement. It discusses how my approach to patient care has been challenged and analyses how evidence based practice can create a change in the way patients are cared for. It reviews the processes of managing the perioperative environment and evaluates the implications for practice when applying a change in healthcare. Wicker and O’Neill (2010) state that “The lack of immediate medical support in the recovery room means that practitioners work in a more autonomous role than any other area of the operating department” (p.379). By reflecting upon my experiences I am able to link practical and theoretical aspects of the operating department practitioner (ODP) job role. This will provide me with a greater understanding of professional practice and it will develop my personal knowledge and self-awareness (Forrest, 2008). Using a model of reflection is important as it provides a framework that can be systematically followed and acts as a guide through the process of reflection. For this essay I have chosen to use the Gibbs’ Reflective Cycle (1988) as it provides a methodical guide to reflection using a series of ordered questions that each lead to the next stage of the cycle (Forrest, 2008).

While there was a policy in place for conscious sedation, even good policies rely on the vigilance of staff to adhere to them. Often times, working conditions allow for distractions, and even the best of practitioners, with the best of intentions, make errors. There were several areas presented in this scenario that require examination and improvement.

* Personnel Issues: One of the key barriers to effective interaction for the pre-op nurses is that they are not getting any information from the registrar or the surgeon related to the patients unique circumstances. There is not a communication process in place for the pre-op nurse to actively communicate with the surgeon or his office regarding a patient’s care during their day of surgery. An additional factor in this situation was the pre-op nurse documented the mother’s contact information in her notepad, but not on the

A policy for conscious sedation was in place and not followed by staff. As all staff had been trained in the procedure, completed the appropriate modules, and

Does the compliance with a sedation protocol improve after nurses receive a sedation competency over a three month period?

Patients with physical or mental disabilities should be sedated in order for them to get the proper dental care that they need because they may not be able to cooperate during the procedure. As stated by Dr.Bain, D.D.S, Patients with medical conditions such as Down’s syndrome and cerebral palsy may have physical limitations that keep them from sitting comfortably in the patient chair and staying still during dental treatment. Patients with physical disabilities may have a hard time remaining calm. The physical disability of the special needs patient may cause them to fidget and move around a lot. This can make it more difficult for them to keep their head straight or their mouth open for the dentist. In addition, patients that lack good communication skills may also have a hard time cooperating with treatment because they are unable to communicate to the dental staff or their caregiver any discomfort or pain they feel during treatment. This makes it harder for the dentist to complete the treatment correctly because the patient may have a difficult time informing their needs to the dentist or the assistant. As a result, the patient will not be able to cooperate with treatment if they are experiencing pain or discomfort. If the patient can not communicate to the dental staff that something is causing them pain or discomfort the patient is not only going to be very uncomfortable, but they are also going to remember the procedure as a traumatic

During the second week, I had the opportunity to accompany Mr. Price to meetings that he had with the managers of the nurses and schedulers. During those meetings, the managers discussed the ideal approach of how to accommodate patients who call the schedulers to acquire appointments for urgent medical concerns. There seemed to be a problem with patients taking up appointment slots when they do not have a true need to be assessed by their doctor. It was ultimately concluded that the schedulers would coordinate communication between the patient and the registered nurse. The nurse would then triage the patient’s concerns over the phone and provide medical guidance,

The pediatric clinic provided well check-ups, sports physicals, vaccinations, sick visits, referrals. These services are by appointment, if a walk in comes in they will schedule them for an appointment or recommend going to the urgent care. When a patient called with a child running a 103 degree fever the nurse recommended to go to St. Fancies children’s hospital Emergency room.

The discharge criteria in the policy states the patient will be fully awake, vital signs stable, no nausea or vomiting, and the patient is able to void. All practitioners that provide moderate sedation must complete a training module prior to providing moderate sedation, this includes personnel assisting with the procedure. The first process failure was not meeting the required monitoring of the patient as mandated by the moderate sedation policy. In the absence of ECG or respiratory monitoring the sedation administered produced apnea then asystole without ED personnel being aware of acute changes in the patient’s condition. There is no explanation for why the patient was not on continuous ECG monitoring. Equipment was found to be in good working order.

satisfied with the sedation level and ordered an additional dose of each of the medications only

Anesthesia was developed in order to block or prevent pain during medical procedures. Anesthesia has been the backbone of the medical world for around 100 years now. Early anesthetics were primitive and many patients simply did not trust anesthetics. Anesthesia is still a risky process even in todays advanced medical world. Anesthesia is not used to treat or diagnose any specific disease; the sole purpose is to aid both the patient and surgeon through procedures. However, anesthesia is used in different ways based on the magnitude of the procedure. There are three levels of anesthesia which include; local, regional, and general anesthesia. An anesthesiologist determines which type of anesthesia will be needed.

Upon arrival a patient should have been made aware about a delay therefore he/she would not get inpatient. The appointment itself should not be rushed. A health proffessional should have explained everything in a clear and precise manner giving patient the opportunity to voice any concern or ask any additional questions. In regards to the appointment itself, the