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Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommentations for practice.

Freely, Kathy and Gardner, Anne 2006, Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommentations for practice., Australian critical care, vol. 19, no. 2, pp. 73-77, doi: 10.1016/S1036-7314(06)80012-3.

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Title Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommentations for practice.
Author(s) Freely, Kathy
Gardner, Anne
Journal name Australian critical care
Volume number 19
Issue number 2
Start page 73
End page 77
Publisher Australian College of Critical Care Nurses
Place of publication North Strathfield, N.S.W.
Publication date 2006-05
ISSN 1036-7314
1878-1721
Summary The quality of sedation management in mechanically ventilated patients has been a source of concern in recent years. This paper summarises the literature on the principles of optimal sedation, discusses the consequences of over and undersedation, highlighting the importance of appropriate pain management, and presents a case study using the results of an audit of 48 mechanically ventilated adults. As a result of the review and audit, we are implementing changes to practice.

The most important recommendations from the literature are the use of a sedation scale, setting of a goal sedation score, appropriate pain management and implementation of a nurse initiated sedation algorithm. Other recommendations include use of bolus rather than continuous sedative infusions and recommencing regular medications for anxiety, depression and other phychiatric disorders as soon as possible. A recommendation arising from our audit was the need to identify patients at high risk of oversedation and undersedation and adopt a proactive rather than reactive approach to management. The practice goal is to provide adequate and appropriate analgesia and anxiolysis for patients. This will improve patient comfort while reducing length of mechanical ventilation and minimising risk of complications.
Notes Available online 13 January 2007.
Language eng
DOI 10.1016/S1036-7314(06)80012-3
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2006, Elsevier B.V.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30009077

Document type: Journal Article
Collection: School of Nursing and Midwifery
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