Analgesia-first sedation titration in the mechanically ventilated patient using validated scales.
Indications
- • Ventilated ICU patient
- • Procedural distress
Equipment
- • Fentanyl / morphine infusion
- • Propofol / midazolam / dexmedetomidine
- • RASS & CPOT charts
Positioning
- • As appropriate for the procedure and patient comfort.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/5)
Tap to complete
CPOT for pain; RASS for sedation goal typically 0 to -2.
Immediate complications
- ⚠ Hypotension
- ⚠ Over-sedation
Delayed complications
- • Propofol infusion syndrome
- • Delirium
- • Withdrawal
Recognition
- • Deep sedation
- • Metabolic acidosis
Initial management
- • Reduce/stop infusion
Prevention
- • Daily breaks
- • Analgesia first
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Related in WardRound
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
