Forum.
Summary
There is no good evidence from randomised controlled trials to guide monitoring of patients whilst sedated. Clinical guidelines do not address monitoring of the patient or care of the family whilst the patient is sedated. Validated monitoring tools are in use for monitoring the sedated acute-care patient, but many involve physical stimulation of the patient. However, some measurement tools require only observational measurements, and these may be adaptable to the sedated palliative care patient. Because comfort and self-preservation responses may be absent in the sedated patient, depending upon the depth of sedation, any monitoring system should include recognition of and attention to the consequences of these absences. Sedation assessment in palliative care should be commensurate with patient and family goals of management.
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