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Sedation in ICU

The document discusses sedation in the intensive care unit (ICU). It begins by outlining the objectives and goals of sedation in the ICU, which include patient comfort, pain control, anxiolysis, prevention of complications, and facilitation of care. It then describes the ideal characteristics of sedation agents and challenges of ICU sedation. It defines agitation and discusses its causes. It also reviews common sedative medications used for analgesia and anxiolysis, noting pros and cons. Finally, it introduces the Richmond Agitation-Sedation Scale for measuring patient sedation levels.

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Ihtesham Ul Haq
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135 views14 pages

Sedation in ICU

The document discusses sedation in the intensive care unit (ICU). It begins by outlining the objectives and goals of sedation in the ICU, which include patient comfort, pain control, anxiolysis, prevention of complications, and facilitation of care. It then describes the ideal characteristics of sedation agents and challenges of ICU sedation. It defines agitation and discusses its causes. It also reviews common sedative medications used for analgesia and anxiolysis, noting pros and cons. Finally, it introduces the Richmond Agitation-Sedation Scale for measuring patient sedation levels.

Uploaded by

Ihtesham Ul Haq
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Sidra Yousaf, RN

Objectives
 By the end of this presentation the participants will be able to:
 Know goals of sedation.
 Recognize characteristics of good sedation.
 Define Agitation.
 Understand sedatives pharmacology.
 Explain Richmond Agitation-Sedation Scale
Goals of sedation in the ICU
 Patient comfort
 Control of pain
 Anxiolysis and amnesia
 Adverse autonomic and hemodynamic responses
 Facilitate nursing management
 Facilitate mechanical ventilation
 Avoid self extubation
 Reduce oxygen consumption
Characteristics of an ideal sedation agents for the
ICU

Lack of respiratory depression


Analgesia, especially for surgical patient
Sedation with ease of orientation and arousability
Anxiolytic
Hemodynamic stability
The Challenges of ICU Sedation

 Altered pharmacology
 Tolerance
 Delayed emergence
 Withdrawal
 Drug interaction
What is AGITATION

 A syndrome of excessive motor activity, usually non-


purposeful and associated with internal tension.
 1.Violent motion.
Causes of Agitation

 Pain
 Anxiety
 Fear
 Withdrawal
 Depression
 Patient-Ventilator interactions
 Sleep Deprivation
Sedation in ICU

Continuous or Analgesia ?
Intermittent ?

Anxiolytic ?
Analgesia
Morphine Fentanyl
Hydromorphone +Short acting
+BP neutral

Fentanyl Morphine
+Air hunger

Hydromorphone
+Good for opioid
tolerant patient
Anxiolytic
Propofol
+Short acting
_Hypotension
Benzodiazepines _Bradycardia
Propofol _Hyperlipidemia

Benzo’s
+ Alcoholic withdrawal
+BP neutral
_Delirium
Haloperidol
Haloperidol
+Short acting
+BP neutral
+Delirium
_QT prolongation
 It depends on the patients!
 Target RASS +4 to -5
Richmond Agitation-Sedation Scale

 Richmond Agitation-Sedation Scale is a medical scale used to


measure the agitation or sedation level of a patient. The RASS
can be used in all hospitalized patients to describe their level
of alertness or agitation. mostly used in mechanically
ventilated patients in order to avoid over and under-sedation.

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