Assessment of sedation level and pain should be documented at least every 15 minutes. The Richmond Agitation Sedation Scale (RASS) or equivalent should be used to document level of sedation or consciousness. ECG should be monitored continuously and the ST segment should be measured. Continuous pulse oximetry is also required during and after a moderate sedation procedure. Noninvasive blood pressure (NIBP) should be every 15 minutes post procedure to determine the need for volume or vasoactive medications. Most cardiologists will set a systolic or mean arterial pressure (MAP) goal. Pain medication and/or nitroglycerine may be infused to keep chest pain to a minimum. Access or sheath site should be assessed every 15 minutes for the first hour as well.
If the patient had an intervention, expect to repeat the 12-lead ECG after the procedure in the recovering area. Cardiac enzymes and CBC may be ordered to assess platelet count on initiation of fibrinolytics and should be repeated 6 hours while infusing. For diagnostic cardiac catheterization, only recovery from sheath puncture and sedation will be required before discharge.