Management of complications during moderate and deep sedation: respiratory and cardiovascular considerations

Abstract

The risk for complications while providing moderate and deep sedation is greatest when caring for patients already medically compromised. It is reassuring that significant untoward events can generally be prevented by careful preoperative assessment, along with attentive intraoperative monitoring and support. Nevertheless, we must be prepared to manage untoward events should they arise. This continuing education article will review critical aspects of patient management of respiratory and cardiovascular complications.

Figures

Figure 1

The primary assessment. Components of a primary assessment and conditions they reveal.

Figure 2

Devices for oxygenation and ventilation. (Compilation from personal slides and slides modified from the American Heart Association.)

Figure 3

Abridged version of advanced cardiac life support (ACLS) cardiac arrest algorithm. Once primary assessment confirms cardiac arrest and emergency medical services (EMS) with ACLS capability is alerted immediately, the office team following the 2005 American Heart Association (AHA) algorithm may not reach the administration of antiarrhythmic drugs before help arrives.