Minimum requirements for safe sedation are outlined in the tables below.
Resourcing by setting
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| Resource | Standalone public facility | Hospital without critical care medical emergency team | Hospital with 24-hr critical care medical emergency team |
|---|---|---|---|
| Audited service | Yes | Yes | Yes |
| Electronic monitoring or recording | Yes | Yes | Yes |
| Staff in facility available for emergencies | < 5 extra staff | > 5 extra staff | Critical care medical emergency team |
Minimum staffing by type of sedation
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| Level of sedation | Standalone public facility | Hospital without critical care medical emergency team | Hospital with 24-hr critical care medical emergency team |
|---|---|---|---|
| Mild sedation | 2 people | ||
| Proceduralist can be sedationist | |||
| Moderate sedation | 4 people | 3 people | |
| Proceduralist cannot be sedationist if shared airway or duration of sedation >1 hour | Proceduralist cannot be sedationist | ||
| Deep sedation | 5 people | 4 people | |
| Only if sedationist is anaesthetist/critical care physician (CCP) | |||
Levels of sedation
Mild sedation: (nitrous oxide or methoxyflurane or oral anxiolytics) + oral opioid analgesic
Moderate sedation: intravenous opioids or benzodiazepines
Deep sedation: propofol
Patient factors
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| Patient management | Standalone public facility AND sedation is mild or moderate | Hospital without critical care medical emergency team | Hospital with 24-hr critical care medical emergency team |
|---|---|---|---|
| Patient can be managed by all proceduralists in their scope of usual practice | ASA 3 | ASA 3–4 | |
| If sedationist is CCP | ASA 1–3 | ASA 1–4 | |
Refer to assessment form for ASA 1–2.
Standalone public facilities are not suitable for procedures with a significant degree of postoperative pain.