FRCA Curriculum – Sedation

Competence Source Curriculum Description
CS_BK_01 Basic Can explain:

  • What is meant by conscious sedation and why understanding the definition is crucial to patient safety
  • The differences between conscious sedation and deep sedation and general anaesthesia
  • The fundamental differences in techniques /drugs used /patient safety
  • That the significant risks to patient safety associated with sedation technique requires meticulous attention to detail, the continuous presence of a suitably trained individual with responsibility for patient safety, safe monitoring and contemporaneous record keeping
CS_BK_02 Basic Describes the pharmacology of drugs commonly used to produce sedation
CS_BK_03 Basic Explains the need for and means of monitoring the sedated patient including the use of commonly used sedation scoring systems
CS_BK_04 Basic Describes how drugs should be titrated to effect and how the use of multiple drugs with synergistic actions can reduce the therapeutic index and hence the margin of safety
CS_BK_05 Basic Describes the importance of recognising the following when multiple drug techniques are employed:

  • Increased potential for adverse outcomes when two or more sedating/analgesic drugs are administered
  • The importance of titrating multiple drugs to effect whilst recognising that the possibility of differing times of onset, peak effect and duration, can result in an unpredictable response
  • Knowledge of each drugs time of onset, peak effect, duration of action and potential for synergism
CS_BK_06 Basic Can list which sedative drugs should not be given to the elderly [over 80 years of age], with reasons
CS_IK_06 Intermediate Discusses the unpredictable nature of sedation techniques in the ‘extremes of life’ and strategies for safe delivery [cross ref paeds]
CS_BK_07 Basic Can explain the minimal monitoring required during pharmacological sedation
CS_BK_08 Basic Describes the indications for the use of conscious sedation
CS_BK_09 Basic Describes the risks associated with conscious sedation including [but not exclusively] those affecting the respiratory and cardiovascular systems
CS_BK_10 Basic Can explain the use of single drug, multiple drug and inhalation techniques
CS_BK_11 Basic Describes the particular risks of multiple drug sedation techniques
CS_BK_12 Basic Outlines the unpredictable nature of sedation techniques in children [Cross ref paediatrics]
CS_BK_13 Basic Explains the need for robust recovery and discharge criteria when conscious sedation is used for out-patient procedures and the importance of ensuring appropriate escort arrangements are in place [Cross ref day surgery]
CS_IK_01 Intermediate Explains what is meant by ‘deep sedation’ and when its use may be justifiable, identifies the associated risks and how these may be minimised to ensure patient safety is not compromised [Cross Ref sedation]
CS_IK_02 Intermediate Discusses how multiple drug use may enhance sedation techniques, whilst detailing how this increases risks
CS_IK_03 Intermediate Explains why it is essential to titrate multiple drugs [sedatives, analgesics and anaesthetic agents] to effect whilst recognising that the possibility of differing times of onset, peak effect and duration, can result in unpredictable responses
CS_IK_04 Intermediate Discusses the place of infusions compared to bolus doses as well as target-controlled infusions [TCI], and the pharmacological models and pump technology relevant to their use
CS_IK_05 Intermediate Discusses options for ‘alternative’ route of delivery of drugs used for conscious sedation including intra-nasal and rectal