• Professional delivering sedation
  • Specialty/Speciality
  • Grade
  • Required expertise in delivering study intervention (study team to define)
• Setting of where sedation given
  • Hospital location (describe type of hospital including number of beds)
    • Operating suite
      • Ambulatory (day-case)
      • Non-ambulatory
    • Other hospital location (please specify)
    • Intra-hospital transfer
  • Non-hospital location (please describe)
    • Inter-hospital transfer
    • Non-transfer setting
• Intervention components
  • 1. Pre-procedural medications if given (additional to patient's usual medications)
    • Drug name
    • Drug dose (units)
      • Dosing metric
        • Absolute dose
        • Per body weight
        • Other
    • Route of administration
    • Time of administration (including over what time period drug administered if applicable)
    • Reason for administration
  • 2. Procedural Sedation
    • Patient positioning (please state)
    • Monitoring
      • ECG
      • Oxygen saturations
      • Non-invasive blood pressure
      • ETCO2
      • Temperature
      • Processed EEG
      • Respiratory rate
      • Other
      • Frequency of monitoring
    • Supplemental oxygen (Yes or No)
      • Nasal cannulae
      • Mask
      • Flow rate
      • Duration
    • IV Fluids
      • Type of fluid
      • Volume or rate
    • Sedation drug(s) used
      • Bolus (Yes or No)
        • Drug name
        • Drug dose (units)
          • Dosing metric
            • Absolute dose
            • Per body weight
            • Other
        • Route of administration
        • Time of administration (including over what time period drug administered if applicable)
      • Infusion (Yes or No)
        • Non-target controlled infusion
          • Drug name
          • Initiation dose (units)
            • Dosing metric
              • Absolute dose
              • Per body weight
              • Other
          • Maintenance dose (units)
            • Dosing metric
              • Absolute dose
              • Per body weight
              • Other
          • Medical device used to deliver sedation
          • Time of discontinuation of sedation
        • Target controlled infusion
          • Drug name
          • Model for drug infusion
          • Medical device used to deliver sedation
          • Plasma targeting (Yes or No)
          • Effect site targeting (Yes or No)
          • Target concentrations including units
      • Other modes of sedation (e.g. volatile), including details of dosing
    • Parameters used for sedation titration
      • Depth of sedation
        • Method of assessment
        • Specified target
        • Timing of assessment
      • Pain
        • Method of assessment
        • Specified target
        • Timing of assessment
      • Other physiological parameters (please describe)
    • Additional drugs given (to be completed for each additional drug)
      • Drug name
      • Drug dose (units)
        • Dosing metric
          • Absolute dose
          • Per body weight
          • Other
      • Route of administration
      • Time of administration (including over what time period drug administered if applicable)
      • Reason for administration
    • Unplanned additional techniques
      • Local anaesthesia infiltration
      • Regional Anaesthesia
      • General Anaesthesia
      • Airway manoeuvre or assistance
      • Other
      • Reason for additional intervention
        • Patient request
        • Patient compliance
        • Haemodynamically unstable
        • Inability to maintain airway or respiratory depression
        • Other
  • 3. Recovery from procedural sedation (until discharge back to usual residence)
    • Medication given post-procedure
      • Drug name
      • Drug dose (units)
        • Dosing metric
          • Absolute dose
          • Per body weight
          • Other
      • Route of administration
      • Time of administration (including over what time period drug administered if applicable)
      • Reason for administration
    • Additional IV fluids
      • Type of fluid
      • Volume or rate
      • Time of administration
    • Monitoring
      • ECG
      • Oxygen saturations
      • Non-invasive blood pressure
      • ETCO2
      • Temperature
      • Processed EEG
      • Respiratory rate
      • Other
      • Frequency of monitoring
    • Initial post-procedure destination
      • Recovery area
      • Post Anaesthetic Care Unit (PACU)
      • High Dependency Unit (HDU)
      • Intensive Care Unit (ICU)
      • Return to the ward
      • Other, please specify
      • Duration at location
    • Subsequent destination(s)
      • Ward
      • Usual residence
      • PACU
      • HDU
      • ICU
      • Other, please specify
      • Duration at each location