Conscious Sedation (Moderate Sedation) in the Office
As the first medical professional liability insurer to establish a patient safety department, The Doctors Company remains the leader in developing innovative tools that can help you reduce risk and keep your patients safe.
Perform and document a thorough pre-sedation evaluation and include an ASA score.
Provide clear preprocedure instructions.
Follow patient safety guidelines.
- Have emergency medications and equipment readily available.
- Have a designated, appropriately educated individual (other than the dentist performing the procedure) present to monitor the patient throughout the procedure.
- Check blood pressure and pulse every five minutes.
- Follow the titration guidelines for oral medications and other sedatives.
- Ensure appropriate postprocedure observation and monitoring.
- Maintain Basic Life Support certification for all dental care staff who supervise, administer, or monitor conscious sedation (moderate sedation).
- Ensure that an appropriately trained individual who can provide airway management (bag/mouth/mask ventilation with oxygen) is immediately available (within one to five minutes).
- Use pulse oximetry, including alarms, routinely.
- Monitor ventilatory function continually by observation, auscultation, or exhaled CO2 for patients whose ventilation cannot be directly observed.
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Turn your alarms on—and keep them on!
By Susan Shepard, MSN, RN, Director, Patient Safety Education; and Ann S. Lofsky, MD (deceased), who was Anesthesia Consultant and Governor Emeritus.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.