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Discussion

sedation help please!!!

My hospital is undergoing big changes in Sedation policy that adversely affect the Radiology Department. I am looking for some info from other hospitals: WHO does your procedural sedation (RN/MD/Anesth); is the Radiolgist credentialled in ACLS (not as common as you'd think); what are your H&P requirements? And most importantly, what monitoring scale do you use: Riker, Ramsey or something else? I need help!!!

Thanks for any replies. You can also send me an email throught the PM system.

RadiologyRN

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Might want to ask this one on the CRNA board? They might be better able to help you and there is more traffic there! Good luck.

RN's provide all of the Moderate Sedation in our Radiology Department with the exception of pediatric MRI Scans. All pedi MRI exams are done under general anesthesia.

We follow a housewide policy outlining the procedure. All physicians involved in Moderate Sedation do have to be "credentialled" however ACLS is not required provided they have completed some other sort of airway management or inservicing... Our anesthesia docs were directly involved in the creation of the policy and provide the oversight for credentialling. It is good for 2 years.Our Rads must complete a sedation plan of care indicating their intent for sedation (be it for anxiolysis or truly moderate sedation) and document an ASA status. An H&P is required also. Our radiologist are not compliant with this so we try to provide an H&P from the referring Doc. It has to be less than 30 days old- or the Rad's have to update the H&P. In an effort to help the docs, we do provide a short form H&P that is basically fill in the blank.

Regarding scales: We use Aldrete for discharge criteria and the Ramsey for sedation scale.

nurses do sedation and have to go thru a competency. Ramsey scale is used.

  • Admin

Ours is basically like Hawk's (only, being a VA facility we don't do peds; at my previous place of employment, dept of anesthesia handled all peds sedations. We also used our own LOC scale on the sedation sheets -- not labeled ramsey as such, but very like. Rads didn't have to have ACLS -- which I thought was unfair and not right for the pts, since we had to have it).

Current facility: some changes need to be made, but the sands of change flow slowly. :(

Our Hospital Policy says"qualified" personel, therefore Rad Techs are allowed to push all drugs under a phys orders as long as they are "present". We all know how that goes. THey have recently added that you must be ACLS as well. We all take a 10 question moderate sedation test annually.

Our policy is also like hawks..I am in Texas. We(the nurses) are all required to have ACLS and take an annual sedation test. We use aldrete and ramsey and we take vital signs q 5 minutes during the procedure. We must monitor pt for at least 30 minutes post procedure.:monkeydance:

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