Radiology - Nurse-led sedation during Interventional Radiology Procedures

This leaflet explains what Nurse-Led Sedation is, and why it is going to be used during your procedure in the radiology department. It also explains the benefits and risks of using sedation and what it might feel like.

Importantly, it tells you what you will need to plan for your care after sedation.

What is intravenous sedation?

Intravenous sedation is when a sedative (sedation medicine) is injected into your bloodstream (vein) through a small plastic tube (cannula).

‘Sedationist’ is the name given to the healthcare professional who does this, this will be the Radiology Nurse, under the guidance of the Consultant Radiologist.

They are trained in giving the right amount of sedative and managing any side effects and will stay with you all the time during your treatment.

You will be given light or moderate sedation (conscious sedation), so you will feel relaxed and drowsy. Importantly though, you will be awake and your sedationist can still talk with you and you will still be able to follow simple instructions. You may remember some parts of your treatment.

What are the benefits of intravenous sedation?

• It is quick acting, and the dose can be adjusted so you get just the right amount
• It allows you to be more relaxed during your treatment. It may also mean that you remember very little about your treatment afterwards
• It usually has fewer side effects than a general anaesthetic
• Recovery is quicker than after a general anaesthetic, so you can usually go home within a few hours of your treatment if you feel well

What are the risks of intravenous sedation?

• Your breathing rate may become slow. The sedationist is skilled in monitoring you and can assist your breathing if required.
• It is common for your blood pressure to drop, but the sedationist is trained in treating this too
• Feeling sick or vomiting can happen but is uncommon
• Any allergic reaction to the sedation drugs is very rare
• You may have a small bruise where your cannula was placed or attempted
• Afterwards you may feel less steady on your feet, and you may be at higher risk of falling, especially if you are elderly
• Sedation can affect your judgement and memory for up to 24 hours

The radiology nurse will carry out a full assessment, looking at your medical history and any medications that you are taking. This will help decide if nurse led sedation is appropriate for you.

You may be asked to see an anaesthetist for a further assessment if you have any of the following:

• Have difficulties lying flat
• Have problems with your kidney’s
• Have difficulty swallowing (dysphagia)
• Have had previous problems with sedation or anaesthetic drugs
• Have had a previous stroke, TIA, or heart attack
• Have chronic breathing problems, such as COPD or unstable asthma
• Have sleep apnoea
• Take strong painkillers or other sedation drugs

I’m having sedation, what should I do before I come to the hospital?

• If you have people that you look after, for example children or old people, you will need to plan for someone else to look after them until the next day
• A capable adult will need to take you home by car or taxi – ideally not public transport. As the effects of the sedation can last up to 24 hours, they should stay overnight to look after you. If this is not possible then an overnight bed at the hospital will be arranged.  Please inform the radiology department if you do not have a capable adult to take you home or stay with you overnight
• Take all your medicines to hospital with you, including any inhalers you use
• If you have an illness, a cold or you are pregnant, please contact the radiology department as it may not be safe for you to have sedation. Your treatment may have to be rearranged 
• Let the Consultant Radiologist know on the day of your procedure if you are breastfeeding
• Remove all makeup – including nail varnish and jewellery before coming to hospital. You may wear a wedding band
• Bring some loose clothing, such as a dressing gown or a fleece, to keep you comfortable and warm. Wear flat shoes that are easy to put on

Can I eat and drink before my treatment?

You will need to stop eating six hours before your procedure, but you may drink clear fluids up to two hours before your procedure. Clear fluids you will be allowed to drink include water, diluted juice (no bits) and black tea or coffee (no milk or cream).

If you have diabetes, you should ask for specific instructions about when you should take your medication and stop eating food from your diabetes specialist team.

What will happen before my procedure?

You will be admitted to the Day Case Unit and change into a gown, you may also have some blood tests.

You will go to the Radiology Department; the radiology nurse will introduce themselves and go through some safety checks. A small plastic tube (cannula) will be put into a vein in your arm or hand.
 
The radiology nurse will attach some monitoring equipment to you.

This will include:
•    A blood pressure cuff on your arm
•    Leads on your upper chest to record your heart rhythm
•    A clip on your finger to measure your oxygen levels
•    A thin plastic tube that measures the amount of carbon dioxide that you breath out. This is attached to a plastic tube that sits in your nose which will give you some oxygen to breathe

How is intravenous sedation given?

•    The sedation is given though a drip (cannula) which is put into a vein in your arm or the back of your hand
•    Once it has taken effect the radiologist will start your procedure
•    You will not be asleep, but you should feel relaxed enough to tolerate the procedure and communicate with the staff in the room

When can I go home?

• As you are having light or moderate sedation, you can usually go home within a few hours of your treatment if you are feeling well. This will depend on the type of procedure you are having, you may be required to stay in hospital overnight, this will be planned in advance of your procedure

Are there any important instructions for afterwards?

• You will go back to the Day Case Unit after your procedure
• The monitoring equipment will be kept on and your blood pressure, heart rate, breathing rate and oxygen levels will be regularly checked for one hour
• Sedation may make you unsteady on your feet. Please be careful on stairs and have somebody with you if you feel unsteady
• Your decision making may be affected for up to 24 hours after your treatment, so you should not make any important decisions during that time. Be careful if using social media
• You should not return to work, look after dependents, drive, cook or operate any machinery for 24 hours. It can take 24 hours for the drugs to leave your body
• You should not take any alcohol or sleeping tablets for 24 hours after the procedure
• You will be given any aftercare advice if necessary

Who to contact

Salford Radiology Nursing Team (Angiography Suite)
Tel: 0161 206 2206 (8am - 6pm Monday - Sunday)

Oldham Radiology Nursing Team (Interventional Radiology Day Case Unit)
Tel: 0161 778 5314 (8:30 am - 5.30pm Monday - Friday)

If after the procedure you are concerned, feel unwell, you can call your GP, ring 111, or go to your local Accident and Emergency Department with a capable adult if necessary.

If it is a query relating to a follow up from your procedure, please contact your specialist nurse or referring team.