Escort Post Operative Instructions

POST-OPERATIVE INTRAVENOUS (IV) SEDATION INSTRUCTIONS FOR THE ESCORT:

1. All patients must be accompanied in recovery. Patients may sleep, but must be watched for at least 6 hours after treatment. Following sedation, a responsible adult, over 18 years old (with a valid government issued identification), must escort the patient home. A responsible adult should remain with the patient for the next 24 hours.

2. A parent or legal guardian must accompany minors home.

3. Following IV sedation, patients should refrain from driving a vehicle or engaging in any activity that requires alertness for the next 24 hours. The patient cannot drive home. The patient is prohibited from going up and down stairs unattended until fully recovered.

4. Please escort the patient from the vehicle to the house by supporting them under the arm.

5. The patient must be conscious and aware before any additional pain medication can be given. Wait at least 6 hours, or as directed by your doctor.

6. The patient needs to drink plenty of liquids as soon as possible. The patient can eat whenever he/she desires.

7. Please call our office Spring-Klein Oral & Maxillofacial Surgery Phone Number 281-547-0839 if you have any questions or difficulties. If it is after hours, follow the prompts to be connected to our answering service.

POST-OPERATIVE INTRAVENOUS (IV) SEDATION INSTRUCTIONS

PATIENT RELEASE:

I am escorting _____________________________ home. I understand the patient has been sedated. I have received a copy of the post-operative instructions for the sedated patient and they have been reviewed with me by Dr. Sitters and/or a representative of Spring-Klein Oral & Maxillofacial Surgery. I understand and agree to follow the instructions. I’ve had the opportunity to ask any questions I may have.

Print Escort name________________________________ Phone #:______________________________

Escort Signature ___________________________________________ Date: ______________________

Print (Dr/Office Representive): __________________________________________________________

Witness Signature: _________________________________________ Date: ______________________

 

 

***A valid copy of government issued identification must be present on day of surgery***