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Sedation Management Essay

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Sedation management is a necessary element in the care of mechanically ventilated critically ill children. Sedation is used in the pediatric critical care unit for various reasons, such as to reduce patient pain and anxiety and to decrease agitation; sedation also is used to facilitate mechanical ventilation, prevent the displacement of endotracheal tubes, and decrease cellular metabolism (Keogh, Long, & Horn, 2015). The role of sedation titration is to ensure a patient’s comfort. At my practicum site, management of sedation in pediatric patients is a concerning issue. Sedation currently is managed by nurses based on the physician’s preference. Sedation management in this manner often leads to over sedation or under sedation (Dreyfus, Javouhey, Denis, Touzet, & Bordet, 2017). It is not un-common for a patient who was sedated on mechanical ventilation to be re-admitted to the the intensive care unit (ICU) after discharge due to poor sedation management. The patient, therefore, has an increased length of stay, complications of immobility, and an increase in hospital costs (Beck & Johnson, 2008; Verlaat et al., 2013). This leads to increase frustration from nursing staff, as they …show more content…

The potential positive social change implications of sedation management guidelines includes the development of an effective guide that nurses can use in the care of sedated patients and better patient outcomes. With the use of evidence-based practice guidelines, patients’ length of stay in the ICU, and the hospital as a whole, will be decreased, and the nursing practice in critical care will be enhanced with the use of evidence-based practice

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The CIWA evaluation tool is sometimes replaced with the Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method (CAM) assessment tools when patients reside in the ICU.24 These are well validated tools that evaluate the level of a patient’s agitation versus sedation and presence or absence of

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Mr. A is admitted to the critical care unit post bowel resection, splenectomy, acute respiratory distress syndrome (ARDS) and patient-ventilator dyssynchrony (PVD). He is an eighteen-year-old African American man who is placed on an IV infusion of Norcuron and Ativan. The major outcomes expected for Mr. A would be for him to be able to wean of the ventilator, be hemodynamically stable, heal adequately, tolerate his diet, have adequate bowel elimination, and be able to adjust to his life with optimal functioning. The problems that are to be manage include, being on the ventilator, being sedated, having an elevated temperature, having a low hemoglobin, post surgical bowel resection, splenectomy, hypoxia and diet intolerance.

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