April 16, 2001
Questions to Ask Before Conscious Sedation
Kathleen Allen, RN
Versed (Midazolam), like many other sedatives, is a respiratory depressant. Take too much, and you stop breathing.
Because of this, the act of administering conscious sedation ( the accepted descriptive term for this form of anesthetic ) is tightly regulated by agencies that inspect and accredit hospitals and health care agencies (i.e., JCAHO, individual state regulatory agencies). The definition of conscious sedation has been expanded over the last few years to include nearly every sedative given to render patients more able to tolerate procedures. The rules are very rigid. A hospital's accreditation can be pulled or downgraded if violations are found. ( No accreditation means no Medicare funding!! )
- To be sedated at a hospital, there must be
- - a firm, written, and always followed, how-to do-it policy
- cardiac and respiratory monitoring
- a person assigned to do nothing else but monitor and be available to the patient
- full resuscitative equipment, which is easily accessible.
- Because inspection agencies have not begun inspecting doctors' offices for such conditions ( with the exception of offices which maintain day surgery areas, like plastic surgeons ), there still may be offices not in compliance with these rules. ...but the rules exist. I will not claim that sloppiness results in non-regulated offices, but the rules are there for a reason: to protect the patient.
How to make sure that you are given enough sedation?
- - Ask before you begin, "Who is the person looking out for me during this procedure, and does that person have other responsibilities?"
- Tell that person and the MD doing the procedure about your past experiences, your concerns, and your needs...i.e., what drugs you plan to use, your customary sedating regimen, comfortable or not comfortable.
- Discuss these matters, face-to-face DO NOT WAIT until you are lying down.
- If there is not one designated person assigned to your needs and only to your needs, consider having the procedure done elsewhere, under different circumstances.
- My carefully considered thoughts only...take them for what they cost you...$00.00.
Kathleen Allen, RN