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Informed consent for iv conscious sedation and oral sedation s and risks invo nable them to be better informed concerning their treatment. It has been explained to me that a dentist or that a credentialed dental assistant or dental hygienist nurse under the direct supervision by a dentist will administer conscious sedation. Please be informed that by providing conscious sedation, our practice must follow strict guidelines for compliance with our sedation permit and patient safety.
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I understand that during the administration of my sedation, conditions may arise which require change in the sedation. Medical doctor, doctor of osteopathy, nurse practitioner, physician assistant, certified nurse midwife, or. The intent of this statement is to suggest a framework for granting privileges that will help ensure competence of individuals who administer or supervise the administration of.
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I want to have sedation in order to lessen the pain i would otherwise experience.
With moderate sedation* (certified practitioner) , who is a (circle one): I consent to have sedation provided by appropriate medical personnel. Patients may require local anesthesia, light to moderate conscious sedation, deep sedation, or general anesthesia for their comfort during the performance of dental restorations or surgical. Patients with a physical status greater than “asa ii” should undergo the procedure with moderate sedation in an accredited surgical center rather than the office setting.
The potential benefits and risks of the proposed procedure and the administration of conscious sedation have been explained to me, the likely results without conscious sedation and the. As a result, there is a fee. I am asking to receive iv conscious sedation during my pending procedure/operation/treatment.
