Obtaining Consent: Ensure that informed consent is obtained and documented before the laryngoscopy procedure. Provide the patient (or their parent/carer if under 19) with both verbal and written information about the procedure, including the sedation technique proposed, alternatives, and associated risks and benefits to enable an informed decision. Confirm that the patient understands this information and is involved in the decision-making process.
Pre-procedural Assessment: Conduct a thorough pre-sedation assessment by trained healthcare professionals, documenting the results in the healthcare record. This assessment should include evaluation of the patient’s current medical condition, surgical history, weight, past medical problems (including any previous sedation or anaesthesia issues), current and previous medications (including allergies), physical status with particular attention to airway assessment, and psychological and developmental status.
If there are concerns about airway or breathing problems, or if the patient is classified as ASA grade 3 or higher, seek specialist advice before proceeding. Confirm fasting status according to sedation depth and urgency of the procedure, noting that minimal or moderate sedation with maintained verbal contact may not require fasting. Prepare the patient psychologically by explaining the procedure, sensations they may experience, and coping strategies, ensuring the information is appropriate to their developmental level.
Ensure that personnel delivering sedation are appropriately trained and that resuscitation and monitoring equipment are immediately available. Continuous monitoring during sedation should include respiratory and cardiovascular parameters, with documentation in the healthcare record. After the procedure, continue monitoring until the patient has a patent airway, protective reflexes, stable haemodynamics, and is easily roused.
This preparation ensures patient safety, informed consent, and readiness for the laryngoscopy procedure.
NICE CG112