To those of you who provide conscious sedation for in-office procedures, what is your policy on recovery? Do you keep the patient on a cardiac monitor for an hour after the procedure? Or just until they are back to their baseline? Does an RN have to continue to monitor the patient for a certain amount of time or can an LPN monitor the patient? etc.
I don't know if you are looking for specifically in-office, but I work in an ED where I do Conscious sedations. Our policy is we re-vital and reassess every 15minutes for an hour post sedation. If they are not back at baseline by the hour or if there were complications with the sedation specifically, then the time is extended and additional hour. They are maintained on cardiac monitor for the entire hour plus.
I currently work at an ophthalmic ASC and we have very specific policies for our MAC and general sedation cases. Usually if a patient just gets monitored anesthesia care (MAC), we have them in recovery for 15-30 minutes/or until they are back to baseline, and take vitals/reassess every 5 minutes. We don't typically attach MAC patients to a cardiac monitor in post-op.
With our general cases though, we typically have them on a cardiac monitor for an hour after the procedure and give O2 postoperatively as needed. For the first 30 minutes we take vitals/reassess every 5 minutes, then every 15 minutes for the last 30 minutes. Only the RNs are allowed to monitor the patients in our post-op/recovery rooms.
You really need to find your office policy and procedure manual. Conscious sedation protocol had to be specifically spelled out.
In our large, busy, ambulatory surgery center, where there are always plenty of RN's and LVN's to help monitor all patients, RN's can hand off any patient to an LVN after the RN has admitted the patient. For a stable short procedure the RN just write a one sentence note and signs her name, then hands off the patient to an LVN. Ideally the LVN takes stable patients who will not need IV medications.