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Standing Order:
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Start IV of LR or NS to keep vein open (25 ml/hour) on all patients scheduled for sedation.
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May use 0.1 unit of 1% Lidocaine intradermal prior to IV insertion.
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Finger-stick blood sugar or diabetic patients, notify MD of result (for sedated cases).
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Pregnancy test unless post-menopausal or hysterectomy (for sedated cases).
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Pre-Procedure: (Check all that apply)
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Consent for: Colonoscopy w/possible biopsies and/or polypectomy
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Consent for: Hemorrhoid Banding
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Consent for: Sigmoidoscopy w/possible biopsies and/or polypectomy
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Consent for: EGD w/possible biopsies and or/dilation
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Consent for:
• • •
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Medication Reconciliation:
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Noted by:
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Physician's orders:
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Verbal order/Read back:
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Verbal order/Read back:
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Post Procedure : (Check all that apply)
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Post Procedure:
• • •
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See Anesthesia record for sedation medication
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Discharge Orders:
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