CAPNOGRAPHY ADDS SAFETY TO MODERATE SEDATION

Capnography allows us to see a graph of the patient's inspiration as they breathe. This is one of the best addition to in office sedation that I have ever used. When going from minimal to moderate sedation patients can get so relaxed that their breathing depth and pace slows down also. Slowing down is good in sedation but only up to a certain point. The device that measures oxygen levels in the blood has a delayed reaction to the way the sedated patient is breathing, and it takes a while before the oxygen levels have decreased enough on the equipment register to alert the doctor.

A device inside the cannula that can be used for oxygen supplementation also measures levels of carbon dioxide in the expired air. By keeping track of the patient's carbon dioxide levels we can get a pretty good idea of your respiratory drive and your ability to maintain it. Carbon dioxide tells the brain that you need to breathe even when your oxygen levels are high. When your level of carbon dioxide falls and you are already on oxygen supplementation, lowering oxygen allows you to build up carbon dioxide and stimulates the respiratory drive.

Another great device is an EKG that can be attached to the wrists and give us a good idea of your basic rhythms during a long moderate sedation session. EKG, pulse occimeter, Blood pressure, mean arterial pressure, pulse rate, carbon dioxide levels, capnography are parameters that quickly alert us to the level of sedation as well as stimulation and provide us with early warning of an impending medical emergency.

Another safety measure is the reversal agent. Reversing the sedative agent could be one of the first measure when we need to terminate a procedure. The ability to access a vein with an IV or into the bone is an added plus for the patient when doing moderate sedation.

One of the best safety measure is the accuracy of the patient's medical history. Accurate history includes past use of drugs including illicit drugs, operations, medications, history of illnesses, and recent medical check ups. Sedation involves a whole team, and the team consists of not only the people giving care but the patient and their full involvement with their treatment.