Guideline for administration of sedatives and analgesics by physicians who are not anesthesiologists. National Organization for Quality Assurance in Hospitals
Abstract
A consensus text for sedation or analgesia in diagnostic or therapeutic procedures has been developed for application by non-anaesthetist physicians. The final consensus text has the support of 17 scientific societies in the Netherlands. There is not enough medical manpower for direct, personal, specialist-based supervision of level 3 sedation procedures (the patient is relaxed, with eyes closed, but promptly reacts to verbal commands) for significant number of patients in the Netherlands. Sedation and analgesia may be administered by other health care personnel than anaesthesiologists when a number of conditions are met. These concern risk management, information to the patient, patient's consent, requirements for medical and supporting personnel, equipment, sedation procedures, monitoring, data management, recovery and aftercare. The consensus party favours titrated administration of small doses of short acting sedative or analgetic drugs. Combining sedative and analgesic drugs increases risk. Sedation and analgesia in children and patients with mental handicaps is acceptable in terms of quality, but requires special expertise, because of the greater psychic and physical vulnerability of these categories of patients.
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