How to Wean-Off Sedation

Spontaneous Awakening Trial (SAT)

1.Assess if patient is appropriate for SAT, then

2.Sedatives and analgesics should be stopped

3.Analgesics could be continued, as necessary if needed

4.Patient passes SAT if able to follow three out of four simple tasks:

• Open their eyes
• Look at their caregiver
• Squeeze the hand,
• Put out their tongue, or
• Can go without sedation for 4 hours or more without the following:
  • Constant anxiety, agitation, or pain
  • Respiratory rate of 35 breaths/minute for at least 5 minutes
  • Oxygen saturation (SpO2) of < 88% for at least 5 minutes
  • Acute cardiac dysrhythmia or respiratory distress
• SAT could be deferred if any presents:
  • Current RASS is >2
  • The goal is deep sedation
  • Actively seizing
  • Active alcohol withdrawal
  • Active sedative agent dose escalation
  •  FiO2 >50%
  • Neuromuscular blocker use
  • Increased intracranial pressure

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PACU Post Intubation Sedation