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Rabatin sedation China 2006课件
Treating Pain and Agitation in Patients Receiving Mechanical Ventilation (MV);Learning Objectives;Case;Clinical Practice Guidelines;Learning Objectives;Learning Objectives;Agents use to treat pain ;Agents use to treat pain ;Agents use to treat agitation;Agents use to treat agitation;Agents use to treat agitation;Agents use to treat agitation;Learning Objectives;Pain Scale:
1-10 numerical rating scale
Visual analogue scale
Faces scale
FLACC pain scale
Use objective scale appropriate to patient population
;Pain Scale:
Faces scale
;Ramsay Sedation Scale:
1 – anxious, agitated or restless
2 - cooperative, oriented, and tranquil
3 - responsive to commands only
4 - asleep, with a brisk response to a light glabellar tap or loud sound
5 - asleep, with a sluggish response to a light glabellar tap or loud sound
6 - asleep, with no response to a light glabellar tap or loudsound
Ramsay MAE, BMJ 1974;2:656-9;Richmond Agitation-Sedation Scale (RASS)
+4 Combative
+3 Very Agitated
+2 Agitated
+1 Restless
0 Alert and Calm
-1 Drowsy
-2 Light sedation
-3 Moderate
-4 Deep sedation
-5 Unarousable
;Learning Objectives;Kollef et al Chest 1998:
Continuous vs intermittent sedation
Increased duration of MV
increase ICU LOS
;Kress et al NEJM 1998:
Daily interruption of sedation
Decrease duration of mechanical ventilation
Decrease ICU length of stay
No increased number of self extubations
;Algorithm for Patients Requiring mechanical ventilation for 48 hrs;Algorithm for Patients Requiring mechanical ventilation for 48 hrs;Summary
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