Monitoring

Abstract

Recovery from sedation is a dynamic, multiphase process that warrants attentive monitoring by a team of knowledgeable, skillful providers. In addition to automated monitor interpretation and documentation, the team caring for the patient from the immediate postsedation phase through discharge to home or transfer back to the inpatient unit must be knowledgeable about the patient and comorbidities, the procedure just completed, the pharmacologic properties of the sedation regimen employed, and the adverse events that may occur as recovery unfolds, and they must have the necessary skills to navigate and rescue the patient from any such adverse events. Availability of basic and advanced airway equipment, reversal medications, and intravenous fluids is critical. Direct observation with attention to level of consciousness, cardiorespiratory status, temperature, and pain status is required. Monitoring must continue until the patient returns to the presedation baseline state prior to discharge. Written instructions and verbal, interpersonal communication with caregivers are essential to the conclusion of sedation recovery monitoring.