Have you watched the two minute video describing the RASS scoring system that can be accessed from the website
RASS stands for Rochester Agitation and sedation scale
A score of Zero means the patient is unresponsive
There are 9 points on the RASS scale
Positive scores can be made by just observing the patient
Sedation holds are normally prescribed in the morning, but can be prescribed at any time.
Sedation holds are normally prescribed by the medical staff.
When planning a sedation hold we should consider that the patient may be agitated on waking and could remove their endotracheal tube. remove their endotracheal tube.
Sedation holds get patients off ventilators faster, increase their chances of survival and reduce long term psychological distress.
A drug with a half life of 3 hours is started as an infusion at 10ml/hr. It will take at least 12 hours for the drug to arrive at a steady (constant) concentration in the blood. The level of drug will be increasing in the blood during this time.
If the same infusion had been started at 20ml/hr rather than 10 ml/hr it would reach steady state in half the time (6 hours rather than 12)
Giving a bolus dose of a sedative drug will rapidly increase the plasma concentration of the drug
Giving a bolus of 2ml of Propofol may stop the patient breathing and cause their blood pressure to drop.
The half-life of Propofol is 2 hours. We can expect the plasma concentration of Propofol to decrease by half in 2 hours if we turn the infusion off.
Could patients who already know the date and time be irritated by being told again?
There is no point in introducing yourself to someone who is unconscious
If a patient has delirium it's normally obvious
Caecum is a mnemonic for "Causes, environment, communication, unexpected, medications
Have you done the e-Learning course in delirium
Hypoglycaemia is a cause of agitation in critical care
Hypnagogia is the term given to agitation and confusion suffered on first wakening
Olanzapine is commonly given to patients with head injuries
