

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