Imaging Service Sedation for Radiographs

Purpose/ Applicability: The purpose of this SOP is to describe the process of how sedation will be ordered and administered on patients that are obtaining a radiograph exam from the imaging service.

Scope: This SOP shall be applied to small animal patients that are having a radiograph exam by the imaging staff.

Definition(s):
RIS order requisition- order that is placed in SANDI for the radiograph examination

Equipment:
• LAC Cubex- located near imaging in the LAC

Procedure:

1. The service that is ordering a radiograph examination for a small animal patient will place the sedation protocol, including a backup dose into the RIS order requisition when they are entering the order for the exam in SANDI.

1. If the ordering service believes that the patient will need sedation, such as fractious patients. Contact imaging at 355-5330 to discuss a time that is agreed upon by both services. Administer sedation prior to the verbally agreed upon radiograph time, so the patient is ready by the verbally agreed upon time.
2. If the ordering service believes that the patient will not need sedation to obtain a quality radiograph study, the imaging tech will start the exam without sedation.
3. If the patient becomes uncooperative, or too tense for the imaging tech to obtain quality diagnostic images, sedation will need to be given.
4. To keep the RIS worklist moving efficiently, medications will be obtained from the LAC Cubex 
   i. If an imaging student, that has been trained on the use of the Cubex, is in the room during the radiographic exam, the imaging student will go obtain the sedation medication listed on the imaging requisition from the LAC Cubex. The imaging tech will review what the student has drawn up, prior to it being administered to the patient.
   ii. If an imaging student is not present for the radiograph examination, the imaging tech will obtain the sedation mediation listed on the imaging requisition from the LAC Cubex.
      1. The LAC Cubex does not have Methadone. 
      2. If Alfaxalone is the prescribed sedation, someone from the ordering service will have to obtain the medication, administer it, and stay with the patient until the exam is completed.
5. If the sedation does not work to relax the patient and the backup sedation dose has been administered, the imaging tech has the right to send the patient back to the ordering service. The patient will move to the bottom of the worklist, and the ordering service will need to adjust the sedation protocol listed on the RIS order form.

2. The sedation medication will be administered and documented as needed, based on the type of medication that was ordered.
3. After the patient has reached a comfortable level of sedation, the radiographic examination will be completed.
4. Any documentation for the sedation medication will be returned with the patient to their service. It is the responsibility of the service to ensure this documentation is submitted to Medical Records.