Sedation-Analgesia Airway Rescue

Procedure

22222222Department of AnesthesiologyPerioperative Medicine & Pain Management

Rescue Procedure Protocol

Any emergency occurrence from initiation of sedation-analgesia until discharge criteria are met: loss of protective reflexes lack of patient purposeful response to

repeated verbal/pain stimuli (unanticipated level IV sedation)

Unstable vital signs (new dysrhythmias, hypo -hyper - tension, respiratory failure, low SpO2despite supplemental oxygen, etc.)

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33333333Department of AnesthesiologyPerioperative Medicine & Pain Management

Treatment of Respiratory Compromise

First, stimulate the patient. Discontinue the procedure, call for help, alert the attending overseeing the care

Provide jaw lift and provide supplemental oxygen via oxygen mask

If still not breathing, ensure there is an open airway and bag-valve-mask ventilate. Use nasal or oral airways if necessary

Consider reversal Agents

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The following should be done in the event that a patient undergoing moderate sedation unexpectedly loses his or her ability to independently maintain ventilation:

44444444Department of AnesthesiologyPerioperative Medicine & Pain Management

Opening AirwayHead Tilt-Chin Lift

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Opening Airway Jaw Thrust Without Head Tilt

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Opening Airway Oral Airways

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77777777Department of AnesthesiologyPerioperative Medicine & Pain Management

Oral Airway Sizing

The proper length of the airway should approximate the distance between the

chin and the angle of the jaw

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88888888Department of AnesthesiologyPerioperative Medicine & Pain Management

Opening Airway Inserting Oral Airway

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Opening Airway Inserting Oral Airway

The oral airway works by separating the tongue and the back of the throat. Use a tongue depressor to position the oral airway behind the tongue. DO NOT simply push the oral airway into the mouth. Doing so will merely exacerbate the airway obstruction.

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1010101010101010Department of AnesthesiologyPerioperative Medicine & Pain Management

During Rescue, the Qualified Sedation-Analgesia Personnel Must:

Stay with patient and halt the procedure Notify responsible attending immediately Begin interventional measures: airway,

breathing, circulation Initiate ACLS as needed Return to documentation of q 5 minutes VS Consider reversal agents Activate the center’s code blue system or notify

anesthesia services for assistance as required

CALLING FOR HELP IS NOT A SIGN OF WEAKNESS

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