Sedation record template 2025

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  1. Click ‘Get Form’ to open the sedation record template in the editor.
  2. Begin by entering the date and patient information, including their name and gender. Ensure accuracy as this is crucial for record-keeping.
  3. Fill in the physician's name and indicate the reason for sedation by checking the appropriate boxes based on patient criteria.
  4. Complete the medical history section, noting any allergies, current medications, and relevant health conditions. Use the text fields to describe any positive findings.
  5. Assess airway conditions by checking applicable boxes and provide an ASA classification. If necessary, indicate if a medical consultation is required.
  6. Document drug dosage calculations for sedatives and emergency reversal agents, ensuring all calculations are accurate.
  7. Finally, review all sections for completeness before saving or sharing your completed sedation record.

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Sedation-agitation scale (SAS). The Richmond Agitation Sedation Scale the most important tool that is frequently used. Patients who have score of 14 are in state of restless to combative and needs sedation. Those having scores -5 0 are in state of unarousable to alert and calm so that do not need sedation (Table 6).
Codes 99151-99153 describe Moderate (Conscious) Sedation services provided by the same physician who is also performing the procedure or diagnostic service for which the Moderate (Conscious) Sedation is needed.
Essentially, level 4 is equivalent to the general anesthesia you would receive prior to any medical surgery to achieve the deepest level of sedation.
Deep sedation is nearly the same as general anesthesia, meaning that the patient is deeply asleep though able to breathe without assistance. Deep sedation with a medication called propofol is often used for procedures such as upper endoscopy or colonoscopy.
Sedation works by depressing your Central Nervous System to reduce the awareness of your surroundings. There are four levels of sedation. These are minimal sedation, moderate sedation, deep sedation, and general anesthesia.

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The following must be documented, including date and time, at a minimum of every five minutes during the moderate sedation: Heart rate. Oxygen saturation. Respiratory rate. Blood pressure.
There are four stages of general anesthesia, namely: analgesia - stage 1, delirium - stage 2, surgical anesthesia - stage 3 and respiratory arrest - stage 4. As the patient is increasingly affected by the anesthetic his anesthesia is said to become deeper.

dental conscious sedation record form