WHEN PATIENTS ARE SEDATED

There are many procedures where patients are sedated.

In many instances, patients are sedated when undergoing some form of endoscopy.

But endoscopy is not the only type of procedure where a patient is sedated to decrease discomfort as well as improve the procedural conditions.

Some patients have described the endoscopy process as uncomfortable and distressing.

Other patients do not recall the procedures at all.

Nurses have a role in explaining to patients what will happen before, during and after the procedure.

The experiences of high-risk respiratory patients undergoing bronchoscopy with “conscious sedation” have been documented in a study published in the Journal of Clinical Nursing.

The consequences of their findings are applicable to other procedures that require sedation.

Conscious sedation is where smaller doses of sedation and analgesia are given to depress the patient’s consciousness without causing respiratory compromise.

The overall patient experience was negative.

Patients experienced frustration and fear and were concerned about their comfort and safety.

In this study, some patients experienced choking and coughing and were aware during the bronchoscopy.

Finally, the consequences post-procedure was an important part of the patient experience.

This study found

“that some patients are fully aware during bronchoscopy when conscious sedation and analgesia are used and may have full recollection of the procedure with its attendant discomforts. Participants remembered coughing and choking and that they were distressed by it. We also found that awareness during the procedure could lead to the disclosure of information to the patient at an inappropriate time, such as difficulties associated with the procedure, obtaining a biopsy or diagnostic outcomes.”

The authors recommend that the clinicians involved in the procedure should treat the patient as though they were aware during the whole procedure.

Most importantly, with this procedure and other similar types of procedures, is preparing patients for the potential that they may be aware.

Procedures should be enacted that take the possibility of patients being aware into account.

To learn more about patient awareness during sedation,

Saxon, Catherine, et al. “High‐risk respiratory patients’ experiences of bronchoscopy with conscious sedation and analgesia: A qualitative study.” Journal of Clinical Nursing (2017).

We are taking a three week break and will be back in mid-July.