The Academy of Medical Royal Colleges 'Safe Sedation Practice for Healthcare Procedures' guidelines (2013) are the most recent guidelines regarding this. They can be downloaded from https://www.aomrc.org.uk/wp-content/uploads/2016/05/Safe_Sedation_Practice_1213.pdf
Practice should be in line with your hospital sedation policy, and your sedation committee may be able to support you.
The following is an extract which relates to supplementary oxygen:
"Monitoring and the use of supplementary oxygen
Clinical and instrumental monitoring to a degree relevant to the patient’s medical status and the sedation method, must be used. Regular communication with the patient, in addition to putting them at ease, allows monitoring of the level of sedation. Existing guidance for patients undergoing anaesthesia identifies the need for pulse oximetry, ECG and automated non-invasive blood pressure monitoring. If verbal communication is lost the patient requires the same level of care as for general anaesthesia. Where conscious sedation is used and continuous verbal contact with the patient maintained, ECG monitoring is not essential.
Respiratory depression may accompany the use of intravenous sedatives and opioid analgesic drugs. Oxygen, via nasal cannulae, should usually be administered from the commencement of sedation, through to readiness for discharge from recovery, particularly for patients with relevant medical conditions, where multiple drug techniques or anaesthetic drugs are used, or deeper levels of sedation administered. Whilst administration of oxygen prevents hypoxia it may mask hypoventilation. Currently, oxygen administration is not administered in fit patients undergoing brief, simple procedures and its use in this group should be considered a Developmental Standard.
The Association of Anaesthetists of Great Britain and Ireland recommend that continuous waveform capnography should be used to monitor adequacy of ventilation for all patients undergoing moderate or deep sedation, and should be available wherever any patients undergoing moderate or deep sedation are recovered and additionally where:
- ventilation cannot be directly observed, e.g. MRI/CT
- multiple drugs/anaesthetic drug techniques are used, and
- pre-assessment highlights increased clinical risk.”