Imaging Service Sedation

Purpose/ Applicability: 
The purpose of this SOP is to describe the process for imaging techs to quickly obtain sedation medications for patients that require additional sedation in order to complete their imaging exam.

Scope: This SOP shall be applied to small animal patients that are in the imaging room

Definition(s):

• Additional Sedation: Refers to the need for sedation for animals that were not previously sedated or already received a sedative and require more sedation to complete the imaging exam.
• HIS : Health Information System

Equipment:

• Form needed: Imaging Service Sedation Form
• Appropriate-sized syringe for the needed dose of medication
• Needle for the syringe
• Alcohol to cleanse the area of the vein if the patient does not have a catheter

Procedure:

• The service that is ordering an imaging exam will fill out an Imaging Service Sedation Form. The ordering doctor will indicate what sedation the patient has already been given and what further sedation they authorize if necessary to complete the imaging. This form will be signed by a doctor.
• The form will accompany the patient to the imaging room that their exam will be performed in.
• The imaging exam will be performed if the patient tolerates the exam/procedure:

1. 1. If the patient does not tolerate the exam/procedure, then the imaging techs will follow the ordering doctor’s guidelines for additional sedation.
   2. Prior to administering any additional sedation, the imaging technician will double check the calculated milliliters of drug to be administered.
      
      
   3. If dexmedetomidine is authorized, the imaging techs will draw up the prescribed dose of the medication from the ward stock, document on the imaging service sedation form, and administer the dexmedetomidine to the patient. The imaging technician will enter a charge on the patient’s HIS account for the amount of dexmedetomidine administered using procedure code R0001. 
      

      i. If the patient becomes sedate the imaging exam/ procedure will be completed. If the patient does not become sedate, the imaging service will then contact the ordering doctor to see how they would like to proceed.

      ii. Atipamezole will be drawn up at a volume equivalent to the volume of dexmedetomidine administered. For example, if the calculated dexmedetomidine volume is 0.2ml, then 0.2 ml of atipamezole will be administered for reversal. Imaging will have the bottle readily available to draw up and administer emergency atipamezole, in case the patient does not react well to the dexmedetomidine.

      iii. If atipamezole is drawn up, the imaging technician will enter the charge on the patient’s profile using procedure code R0002. 

      iv. The patient will be returned to the ordering service. The imaging technician will notify someone within the ordering service that the patient is back

   4. If butorphanol is authorized, the imaging technician will obtain the authorized dose from the Cubex. The imaging tech will administer the Butorphanol to the patient and document it on the imaging service sedation form. Since butorphanol is a controlled substance, a purple sheet should be completed to reflect drug administration. The completed purple sheet must be attached to the Imaging Service Sedation Form.
      i. If the patient becomes sedate, the imaging exam/procedure will be completed. If the patient does not become sedate, the imaging service will contact the ordering doctor to see who they would like to proceed.ii. The patient will be returned to the ordering service.
      
      
   5. All documentation must be turned into medical records.
      i. Imaging technicians will place completed forms in a bin located in the technician work area.
      ii. Any completed paperwork that is located in the bin will be taken to medical records on a daily basis