Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Sep 1997
ReviewA comprehensive review of sedative and analgesic agents.
The intent of this article is to be a comprehensive, but by no means exhaustive, review of some of the agents used for CS. The major classes and their principal uses are presented: benzodiazepines, for sedation-hypnosis, anxiolysis, and, in the case of midazolam, amnesia; and opiates, for analgesia and sedation. ⋯ One should consider how the interactions between and among these agents can be used for the benefit of the patient undergoing CS, and also the danger in combining agents and the necessity of constant monitoring. The reporting of ADEs is a recurring theme, the value of which cannot be overemphasized in modern medical practice, not only to satisfy accreditation requirements but also to ensure patient safety and improve therapeutic choices of medications.
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The need for sedative therapy in the critical care setting is well established. It is an absolute therapeutic adjunct useful in decreasing both patient morbidity and mortality. ⋯ This article presents an overview of current trends and recommendations. Continuing research into these areas is strongly recommended to ensure consistent and safe practice.
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Conscious sedation has become an important component of practice for many ambulatory procedures. Important factors to maintain the safety of this technique are proper patient selection, slow titration of the medication, continuous patient monitoring, proper education of the individuals administering the medication and monitoring the patient, and appropriate policies and guidelines in place in the ambulatory setting. When patient safety is the number one priority, conscious sedation can be a very effective, practical, and safe technique used in the ambulatory setting.
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The nurse must be aware of her or his role and responsibilities when implementing IVCS guidelines. Nurses performing IVCS must be knowledgeable of state and institutional guidelines for IVCS, medications included in IVCS, and the assessment, monitoring, and documentation required in caring for the patient receiving IVCS. The process of IVCS may seem tedious, but if an institution has clearly defined expectations, as provided in the IVCS guidelines, the process is much more understandable and can be readily instituted. The patient undergoing IVCS deserves the highest quality care possible with the fewest complications, a situation that can be achieved with proper preparation and implementation of an IVCS program.