To develop a multidisciplinary, structured approach for managing sedation and analgesia in the ICU.
Perform patient assessment and optimise the ICU environment.
Regularly perform and document structured patient evaluation and monitoring.
All sedated patients should have a daily sedation plan and Richmond Agitation Sedation Score target.
Select analgesic and sedative medications based upon individualised needs, drug allergies, organ dysfunction( hepatic/renal dysfunction), need for rapid onset and offset of action, anticipated duration of therapy and prior response to therapy.
Titrate analgesic and sedative drugs to a define target, using the lowest effective dose.
Implement a structured strategy to avoid accumulation of medications/metabolites: use scheduled interruptions or intermittent dosing of analgesic and sedative drugs.
Recognise and take steps to ameliorate analgesic and sedative drug withdrawal during de-escalation of therapy.
