Sedative Drug Use

First Things First (assess & treat for the following)

  • Does pt have any life-threatening causes of agitation that require immediate attention?
    • Hypoxemia
    • Hypercarbia
    • Severe metabolic acidosis/alkalosis
    • Severe electrolyte abnormalities
    • Hypotension
    • CNS infection
    • Hypoglycemia
    • Drug toxicity, alcohol/drug withdrawal
    • CVA, intracranial hemorrhage
    • MI
    • Pneumothorax
    • Pulmonary edema
    • Seizure
    • Abdominal pain secondary to perforation, abscess, pancreatitis
    • Endotracheal tube malposition
  • Does pt have any correctable causes of agitation?
    • Delirium/dementia
      • Hepatic encephalopathy
      • Renal failure, uremia
      • Meds/toxins
    • Ventilator dyssynchrony
      • Inadequate ventilation (hypercarbia)
      • Inadequate oxygenation
      • Inadequate tidal volume/flow
      • Obstruction of ETT
    • Endocrinopathies
      • Hypo/hyperadrenocortisolism
      • Hypo/hyperglycemia
    • Distended bladder
    • Sleep deprivation
    • Disorientation/fear
      • Inability to communicate
      • Noise
    • Pain
      • From procedures
      • Decubitus
      • Oral/nasal gastric tubes
      • Oral ulcerations
      • Invasive monitors

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Last updated: May 5, 2010