Sedation

Published: 05/09/2019

Sedation

Learning outcomes:

Builds on the knowledge, understanding and clinical skills in sedation developed in basic level training
To be able to discuss where and when deeper levels of sedation may be indicated
To be able to deliver pharmacological sedation to patients of all ages, safely and effectively, whilst recognising their own limitations

Minimum clinical learning outcome:

To recognise the important principal of minimum intervention, where the simplest and safest technique which is likely to be effective is used to achieve the clinical goal
Provision of safe and effective sedation to any adult patient using multiple drugs if required

NB: All competencies annotated with the letter ‘E’ can be examined in any of the components of the Final examination identified in the FRCA examination blueprint section.

Knowledge

Competence	Description	Assessment Methods	GMP
CS_IK_01	Explains what is meant by ‘deep sedation’ and when its use may be justifiable, identifies the associated risks and how these may be minimised to ensure patient safety is not compromised [Cross Ref sedation]	A,C,E	1,2
CS_IK_02	Discusses how multiple drug use may enhance sedation techniques, whilst detailing how this increases risks	A,C,E	1,2,3
CS_IK_03	Explains why it is essential to titrate multiple drugs [sedatives, analgesics and anaesthetic agents] to effect whilst recognising that the possibility of differing times of onset, peak effect and duration, can result in unpredictable responses	A,C,E	1,2,3
CS_IK_04	Discusses the place of infusions compared to bolus doses as well as target-controlled infusions [TCI], and the pharmacological models and pump technology relevant to their use	A,C,E	1,2
CS_IK_05	Discusses options for ‘alternative’ route of delivery of drugs used for conscious sedation including intra-nasal and rectal	A,C,E	1,2
CS_IK_06	Discusses the unpredictable nature of sedation techniques in the ‘extremes of life’ and strategies for safe delivery [cross ref paeds]	A,C,E	1,2,3
CK_IK_07	Discusses the use of sedation in the high risk patient and the advantages/disadvantages of using general anaesthesia as opposed to sedation to cover necessary investigations/procedures in such patients	A,C,D	1,2,3,4

Skills

Competence	Description	Assessment Method	GMP
CS_IS_01	Demonstrates the ability to select sedation techniques appropriate to management in patients of all ages [above 5 years [cross ref paeds] to the elderly]	A,C,D	1,2,3
CS_IS_02	Demonstrates the ability to administer and monitor sedation techniques to all patients [identified in CS_IS_01 above] for appropriate clinical procedures, safely and effectively	A,D	1,2,3
CS_IS_03	Demonstrate the ability to consider the following when considering the choice of sedation technique: That no one technique is suitable for all patients and that the most appropriate technique is that based on minimum intervention, using the simplest and safest effective technique based on patient assessment and clinical need That techniques using multiple drugs/anaesthetic drugs should only be considered where there is a clear clinical justification, having excluded simpler techniques	A,D	1,2,3

Competence

Description

Assessment

Method

GMP

CS_IS_01

Demonstrates the ability to select sedation techniques appropriate to management in patients of all ages [above 5 years

[cross ref paeds] to the elderly]

A,C,D

1,2,3

CS_IS_02

Demonstrates the ability to administer and monitor sedation techniques to all patients [identified in CS_IS_01 above] for appropriate clinical procedures, safely and effectively

A,D

1,2,3

CS_IS_03

Demonstrate the ability to consider the following when considering the choice of sedation technique:

That no one technique is suitable for all patients and that the most appropriate technique is that based on minimum intervention, using the simplest and safest effective technique based on patient assessment and clinical need
That techniques using multiple drugs/anaesthetic drugs should only be considered where there is a clear clinical justification, having excluded simpler techniques

A,D

1,2,3