Sedation Administration and Patient Monitoring

Implementation Date: 6/2022

Date of Last Revision: 6/2022

Next Review Due: 5/2024

 

Reviewed by VTH Administrative Team: 5/25/2022

Reviewed by VTH Board: N/A

 

Reviewed by Legal Counsel: N/A

Reviewed by Biosecurity Subcommittee: N/A

Subject to modification by the VTH Director without approval.

Policy

Patients in the VTH that receive a sedative drug and/or an anesthetic agent that cause deep sedation or loss of consciousness, must have each dose administered and appropriate patient monitoring documented. This may be done by utilizing the Sedation Administration and Monitoring Record form or an anesthesia flow sheet. 

Completed forms will become part of the permanent medical record.

Guidelines

Patients in the VTH that receive a sedative drug(s) that cause light to moderate sedation, which does not result in deep sedation or loss of consciousness, are not required to use this form; the form may be used if desired.

Each medication dose administered must be documented on a separate line with the time it was administered. For example, if 10 mg (1 ml) of alfaxalone is obtained for the patient but only 5 mg (0.5 ml) is given initially and the other 5 mg (0.5 ml) is given later, the alfaxalone should be documented on two lines with each line indicating 5 mg as the dose administered. 

Completion of the sedation monitoring form or anesthesia flow sheet, with all signatures, will serve as documentation for controlled drug administration. Therefore, controlled drug doses documented on this form do not need to also be documented on a Medication Administration Record (i.e. purple sheet). Completed forms must be returned to medical records through the same process as loose labs.

Definitions (if applicable)

Anesthesia – Administration of one or more medications to produce a state of sleep or unconsciousness that requires the use of an anesthesia monitoring machine. An anesthesia flow sheet is used to document drug administration and monitoring.

Anesthetic Agent – A medication class that that causes loss of sensation with or without the loss of consciousness which includes drugs such as ketamine, alfaxalone, propofol, etc.

Deep sedation- Administration of one or more medications to keep the patient asleep and comfortable. The patient cannot be easily woken up during deep sedation.

Sedation – Administration of one or more medications to produce a state of calm or rest.

Sedative – Medications indicated for sedation. This includes drugs such as dexmedetomidine, xylazine, acepromazine, butorphanol, buprenorphine, fentanyl, methadone, morphine, hydromorphone, etc.

Veterinary Teaching Hospital (VTH): The collective clinical services of the Large Animal Clinic, Midwest Equine, the Small Animal Clinic, and the Veterinary Medicine South Clinic.