GI Diprivan thread

Are you flipping kidding me?!?

If your preceptor is telling you to give an ER patient a "drink" of propofol, s/he should be counseled/disciplined and you should be assigned a new preceptor. I'm wigged out even thinking about it.

I'm not ripping on you at all. I was a critical care nurse for over a decade, and I had my share of idiot moments at the bedside. But I knew my limits. I only wish other nurses who want to play with anesthesia drugs would do it the right way - GO TO CRNA SCHOOL!

i agree. as i said it was 4 years ago,i was a brand new er nurse and watched as she gave the bolus. she did have an ambu bag at the bed side for resp failure but honestly i don't believe she knew all the ramifications of giving the drug. Needless to say, she has precepted many people after me and this year she left to go to be a nurse practitioner. How scared are you now?

There is a joint statement by the AANA and ASA concerning this topic, non anesthesia providers SHOULD NOT utilize this agent during sedation. As you know there is no reversal agent for propofol as it acts on a separate subunit of the GABA receptor than versed (sam with etomidate). A recent closed claim study that payouts for sedation (litigation) using propofol have exceeded that of general anesthesia...the reason, loss of airway. I will post the link sometime tommorrow for your information (I gotta remember where it is on my computer.

have read with interest about diprivan-my daughter was dischared 15 minutes after receiving 40mg of ketamine and a 147 mg of diprivan for an endoscopy-still has neuro defecits and is being worked up-?seizure ?hypoxia ?air embolusim?-this drug doesn't sound as safe as others would like us to believe!!

This is for Merlinmom, the doses you describe sound appropriate and relatively safe for the type of procedure you describe. It is hard to "monday morning" quarterback without having direct knowledge of the case. The neuro deficits could be from a variety of things that could have resulted in the case. You should review the operative record and see what other variables might be involved. I must say I routinely use propofol for induction with a 0.5 mg/kg preemptive analgesic dose of ketamine (my N is well over 200 patients) without any difficulty as of yet. However, your daughter could of had an underlying condition that was exacerbated by the sedation....not necessarily by the agent.

Hope this helps,

Mike