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177

NATIONAL AUDIT INTO THE SAFETY OF DEEP SEDATION

14

Sentinel outcome

includes permanent neurological deficit, pulmonary aspiration syndrome,

or death.

Moderate risk interventions

are administration of bag valve mask ventilation or continuous

positive airway pressure, insertion of laryngeal mask airway or an oral or nasal airway, the

administration of sedative reversal agents (i.e. naloxone, flumazenil), the administration of

anticonvulsants or the rapid administration of intravenous fluids.

Moderate risk outcome

includes unplanned hospitalization or escalation of care.

Minor risk descriptors

are:

Oxygen desaturation: SpO

2

75–90% for < 60 s, airway obstruction

Failed sedation: inability to attain suitable conditions to humanely perform the procedure;

Allergic reaction without cardiovascular collapse;

Alteration in vital signs of 25% from baseline (bradycardia, tachycardia, hypotension,

hypertension); seizure.

Minor risk interventions

include airway repositioning, tactile stimulation, airway suctioning,

and incremental supplementation of oxygen. These events are not associated with

permanent injury therefore there is

no minor risk outcome

.

Minimal risk descriptors

are vomiting or retching, muscle rigidity or myoclonus, agitation or

prolonged recovery with a failure to return to baseline clinical status within 2 hours.

Minimal risk interventions

include administration of additional sedatives, anti-emetics, or

antihistamines. Again, these events are not associated with permanent injury therefore

there is

no minimal risk outcome

.

Severity ratings were also defined by Mason et al.

7

as a sentinel risk by the presence of a

sentinel risk descriptor, intervention or outcome. Moderate risk was defined as the presence

of a moderate risk intervention or outcome. Minor Risk was defined as the presence of a

minor risk descriptor or intervention, and finally, minimal risk as the presence of a minimal

risk descriptor or intervention.

Statistics

Statistical analysiswas performedwith IBMSPSS Statistics forWindows, (Version 23.0Armonk,

NY: IBM Corp 2015). Descriptive statistics were used to express means for all data. Data was

assessed for normal distribution with histograms. Normally distributed data was reported as

mean + standard deviation (SD) and non-normally distributed data was reported as median