How does the propofol sedation program fit into the ASA and Joint Commission definitions of Light/Moderate/Deep Sedation? Do your patients still meet the criteria for Moderate Sedation?
I like to visualize sedation as a continuum though I understand the value of the semantic division of sedation into light, moderate, and deep. Frequently on the form at one of our three facilities which asks the physician in advance his sedation intention for the patient who is next, I will cross out deep with propofol and write in just enough. I can achieve moderate sedation with propofol; I call this zone befuddlement. It is the appropriate level in some cases, say an esophageal meat impaction. My understanding of ASA/JCAHO requirements is that any physician using any sedation should be skilled in rescue, in case the intention to go light or moderate goes awry. My understanding also is that its okay for the non-anesthesia specialist to use deep sedation as long as he/she is credentialed by the individual institution. Wed like to show you NAPS, the free-hand method of just enough. My bias is that though there will be smart machines in the near future, NAPS is better than an infusion p
