59MDWI44-137 governs policies, responsibilities, and administrative procedures for the elective use of moderate sedation for patients.
View 59MDWI44-137 on armypubs.army.mil
It defines sedation terminology, registered nurse qualifications, life support certification requirements, and pre-sedation assessment procedures. It also requires quality assurance reporting and establishes exceptions to policy.
Applies to: This publication applies to all personnel providing moderate sedation at any location under the 59 Medical Wing privileging authority to include all dental and medical facilities at Joint Base San Antonio-Lackland and Joint Base San Antonio-Randolph.
Moderate sedation is acceptable for all ages for Dental only. All other clinical areas are limited to age 13 or over. (paragraph 7)
All personnel (privileged medical staff, RN, and technicians) involved in the care of patients receiving moderate sedation must be certified and current in Basic Life Support (BLS). Privileged medical staff and RNs must have age appropriate advanced life support certification (Advanced Cardiac Life Support and/or Pediatric Advanced Life Support) or an approved waiver, exemption or extension. (paragraph 3)
Oral agents intended to induce moderate sedation (e.g., chloral hydrate) may not be prescribed or dispensed to outpatients for self-medication prior to arrival at the facility (including medication to be given by a parent or guardian to a child or other dependent patient). (paragraph 8)
The pre-sedation H&P examination/assessment shall be performed by a privileged medical staff within 30 days prior to the scheduled procedure date. (paragraph 8)
Mandatory quality assurance items that need to be reported include: Return to presedation Modified Aldrete >1 hour, admission related to complications from sedation, assisted ventilation was required, use of reversal agents, Aldrete Score <8 during procedure. (paragraph 8)