Sedation and analygesia management for mechanically entilated adults: Literature review, case study and recommendations for practice

Feeley, Kathy , and Gardner, Anne (2006) Sedation and analygesia management for mechanically entilated adults: Literature review, case study and recommendations for practice. Australian Critical Care, 19 (2). pp. 73-77.

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Abstract

The quality of sedation management in mechanically ventilated patients has been a source of concern in recent years. This paper summarises the literature on the principles of optimal sedation, discusses the consequences of over and undersedation, highlighting the importance of appropriate pain management, and presents a case study using the results of an audit of 48 mechanically ventilated adults. As a result of the review and audit, we are implementing changes to practice.

The most important recommendations from the literature are the use of a sedation scale, setting of a goal sedation score, appropriate pain management and implementation of a nurse initiated sedation algorithm. Other recommendations include use of bolus rather than continuous sedative infusions and recommencing regular medications for anxiety, depression and other phychiatric disorders as soon as possible. A recommendation arising from our audit was the need to identify patients at high risk of oversedation and undersedation and adopt a proactive rather than reactive approach to management. The practice goal is to provide adequate and appropriate analgesia and anxiolysis for patients. This will improve patient comfort while reducing length of mechanical ventilation and minimising risk of complications.

Item ID: 10286
Item Type: Article (Refereed Research - C1)
ISSN: 1036-7314
Date Deposited: 16 Apr 2010 02:58
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1110 Nursing > 111003 Clinical Nursing: Secondary (Acute Care) @ 100%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920210 Nursing @ 100%
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