MODERATE SEDATION COURSE 2021 November 11, 2021 0 Uncategorized Load QuizSave Quiz This quiz consists of 10 questions. Each question, you are required to provide 3 responses with an answer True [T] or False [F]. In total, you are required to provide 30 responses. To pass this quiz, you will need to answer correctly to 25 out of the 30 responses. Please note that you have only up to 3 attempts to pass the quiz. Your information 1. Regarding drug use in sedation a. The standard initial dose for a healthy 50 year old patient weighing 53kg is as follows: midazolam 2mg and fentanyl 37.5 mcg b. Patients who received topical lignocaine spray can be allowed to eat immediately after completion of gastroscopy if they did not receive sedation c. Respiratory depression is a major side effect of midazolam 2. The following statements are consistent with moderate sedation a. Patient's oxygen saturation usually drops to 95% b. Patient respiratory rate would be 4-6 breaths per minute c. Patient cannot be expected to give a proper consent 3. Regarding drug use in sedation a. Due to the synergistic effect of sedatives and narcotics used in combination, individual drug doses should be reduced b. The initial dose of Propofol alone sedation for a 65 year old patient (ASA I, 60kg) undergoing OGD is 80-100mg over 1 min c. The initial dose of naloxone to reverse respiratory depression in opioid over-sedation is 0.02-0.2mg and can be repeat every 2-3min 4. Regarding drug use in sedation a. When used as combination in a healthy 40 year old female, the initial dose of midazolam is 4mg and fentanyl 75 mcg given over 1-2 min b. In patients struggling during endoscopy, drug top-up with midazolam 1mg should be given every 30 seconds until the patient is well sedated c. The usual starting dose for flumazenil to reverse sedation is 0.5 mg 5. Regarding procedure room assessment a. ‘Time out’ can be performed for an anxious patient after a small ‘calming’ dose of midazolam is given b. IV access should be maintained throughout the entire procedure c. Supplemental oxygen is recommended for all receiving moderate sedation unless there are specific contraindications 6. Please assess the following scenario: During insertion of the endoscope, the patient is noted to have noisy breathing and Sp02 revealed a dropped from baseline 99% to 93%. a. Procedure can continue but examination should be hastened b. Sedation should be deepened to provide more comfort to the patient c. Laryngospasm is a potential complication 7. Regarding the right selection of patients for moderate sedation in gastroscopy. The following patients are considered suitable for endoscopist-directed sedation: a. A 65 year male with well controlled diabetes mellitus and a Mallampati score of II b. A 35 year old male BMI 40, with a history of snoring and a Mallampati score III c. A 70 year old female admitted for giddiness and hypotension after several bouts of hematemesis 8. In assessing your patients for risk of sedation a. A Mallampati score of I would predict risk of airway issues b. Patients with ASA 3 should be considered for monitored anaesthetic care c. Patient who had eaten a cheese sandwich 6 hours before an OGD is not at risk of aspiration 9. Please assess the following scenarios: During insertion of OGD, the patient is coughing continuously and secretions are seen in the mouth. The Sp02 showed a dropped from baseline 99% to 90%. a. Procedure can continue as usual after increasing oxygen flow rate b. An increase in the dose of opioids can be given to reduce tracheal irritation c. Patient’s vital signs and conscious level should be re-assessed 10. The following statements are consistent with moderate sedation a. Patient is responsive after performing a sternal rub b. IV fluids are required to maintain blood pressure in the normal range c. Patient is able to respond to verbal commands 1 out of 2 You have reached the end of the quiz. To review your answer from the previous page, click the previous button. If you are ready to submit your quiz, click the submit button. Thank you. Time's up
