For practices

Patient suitability checklist

A quick guide to check a patient's likely suitability for IV sedation before referring. Answer each question below for an indicative result.

No patient names or identifiable details are entered or stored on this page.

QUESTION 1

ASA grade

American Society of Anesthesiologists physical status classification.

ASA I

ASA II

ASA III

ASA IV or above

QUESTION 2

Obstructive sleep apnoea

No OSA

OSA – treated, CPAP-compliant

OSA – untreated / poor CPAP compliance

QUESTION 3

BMI

BMI under 35

BMI 35–40

BMI over 40

QUESTION 4

Ability to lie flat

Able to lie flat

Limited / unable to lie flat

QUESTION 5

Needle phobia

No significant needle phobia

Severe needle phobia

QUESTION 6

24-hour chaperone

Patients must have a responsible adult with them for 24 hours after sedation.

Chaperone confirmed for 24 hours

No chaperone available

Complete all six questions above to see an indicative result.

This tool provides a general guide only and is not a substitute for full clinical assessment. Final suitability for sedation is always confirmed by our consultant anaesthetist following review of the patient's full medical history.