Based on the depth of sedation continuum published by ASA, which of the following patient responses is MOST consistent with moderate sedation?

  • (A) Purposeful response to verbal or tactile stimulation
  • (B) Purposeful response only to repeated or painful stimulation
  • (C) Reflex withdrawal following a painful stimulus

ASA developed a continuum of depth of sedation to define varying levels of sedation and general anesthesia (Table).

Table: Depth of sedation continuum. Used with permission, from American Society of Anesthesiologists. Continuum of depth of sedation: definition of general anesthesia and levels of sedation/analgesia. Approved October 13, 1999. Amended October 23, 2019. Accessed February 7, 2022. asahq.org/standards-and-guidelines/continuum-of-depth-of-sedation-definition-of-general-anesthesia-and-levels-of-sedation-analgesia

Table: Depth of sedation continuum. Used with permission, from American Society of Anesthesiologists. Continuum of depth of sedation: definition of general anesthesia and levels of sedation/analgesia. Approved October 13, 1999. Amended October 23, 2019. Accessed February 7, 2022. asahq.org/standards-and-guidelines/continuum-of-depth-of-sedation-definition-of-general-anesthesia-and-levels-of-sedation-analgesia

Moderate sedation/analgesia, or conscious sedation, is the state in which a patient has purposeful response to verbal or tactile stimulation. In this level of sedation, the airway requires no intervention to remain patent, there is spontaneous ventilation, and cardiovascular function is typically maintained. This may be in the scope of practice for a supervised sedation practitioner who is trained in moderate sedation and works under the direct supervision of a nonanesthesiologist credentialed to provide sedation for procedures (e.g., physician, dentist, or podiatrist) or an anesthesiologist. A nonanesthesiologist sedation practitioner is trained and credentialed to supervise or administer moderate sedation and to rescue a patient from deep sedation.

Purposeful response only to repeated or painful stimulation is consistent with deep sedation, not moderate sedation.

The presence of reflex withdrawal alone is not considered a purposeful response and thus is not consistent with the definition of moderate sedation.

Answer: A