Conscious Sedation Recoveries

  1. I have a question- when ED sends a patient to EGD, and the patient receives conscious sedation, do you receive the patient back immediately afterwards to do the recovery? Our hospital has started this practice on weekends. Last week I had a guy go to EGD, received 100 of Fentanyl and 5 of Versed. The supervisor told me I would get the patient back AFTER recovery for discharge. I got the patient back 15 MINUTES after the drugs were given.
    My supervisor says that having to watch the guy closely for 1 hour, monitoring him, and checking VS q 15 (Not to mention making sure he is BREATHING) is not a recovery. I don't think this is an appropriate practice!
    I am in charge, I have my own patient load (work nights) and have no idea what is coming in the door next. Haven't they ever heard of calling in recovery? Oh, I forgot. They might have to PAY for it. Anyone else see this as a ridiculous practice?
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  2. 13 Comments

  3. by   kaycee
    Yes on off shifts and weekends we would get the pt back to watch and discharge. They would never call recovery for conscious sedation. We watch and monitor them for an hr and discharge them. We do concious sedation all the time in the ER, so it's usually not a big deal. Besides the pt is still technically an ER pt , right?
  4. by   TexNurse
    Nope, when we send someone to OR or EGD they become an inpatient or an outpatient. They are no longer an ER pt. We do conscious sedation too, but we rearrange staffing so that the nurse involved in the CS doesn't have any other patients. Anyone having CS or any type of anesthesia has to be monitored (cardiac, BP, pulse ox) one on one until stable. Then we can place them on q 15min. That is in our written policy.
    So why have recovery if you don't use them?
  5. by   CATHYW
    originally posted by texnurse
    nope, when we send someone to or or egd they become an inpatient or an outpatient. they are no longer an er pt. we do conscious sedation too, but we rearrange staffing so that the nurse involved in the cs doesn't have any other patients. anyone having cs or any type of anesthesia has to be monitored (cardiac, bp, pulse ox) one on one until stable. then we can place them on q 15min. that is in our written policy.
    so why have recovery if you don't use them?
    our er did the same thing. two nurses were always on call for endo, so while one cleaned up, the other recovered the patient. recovery is recovery, no matter what your supv. said. if the aren't aaox3 (or easily roused and aaox3) and breathing deeply on their own, they aren't recovered!
  6. by   KKERRN
    We also recovery ours for one hour with VS q15minutes and then discharge from ER. We use conscious sedation alot for bone reductions and recovery is until pt awake and VS stable-usually 1-2 hours depending on meds given. Rn staysat bedside during procedure and we have form for VS q5 minutes and rate pt by a recovery scale totalling 10 points. Pt must be 8-10 to be discharged and have a driver.
  7. by   TexNurse
    So do you get patients back from EGD or outpatient procedures and recover in the ER? Just wondering.......
  8. by   ernurse728
    We absolutely DO NOT recover the pt's that go to endo...that is the endo nurses resposibility...once the pt's leave they are removed from the ED system and placed in as an outpatient. I will say that they still try to sneak one back to us every now and then though.
  9. by   CMERN
    In our E.R. the GI doctor comes in brings his own nurse, GI nurse admins the conc. sed. meds., doc does procedure and leaves. GI nurse hangs round for about 30 minutes, hands over paper work to E.R. nurse. E.R. nurse finishes following con.sed. recovery protocol. with Q 15 check. then hour checks till pt passes 8 recovery points then pt is dc'd per protocol..works well with us. Have had no problems wih patients and the GI doc's and Nurse are most considerate and helpfull. three cheers for us on this one at least..
    Last edit by CMERN on Oct 2, '02
  10. by   teeituptom
    Howdy yall
    from deep in the heart of texas


    We also do concious sedation here all the time. And at night and weekends they bring those pesky food bolus pts back from endo for us to recover and later dc. Thats standard. Where we draw the line is sending one of our nurses over to assist in the procedure. except for the occasional newbie who aint seen one.



    doo wah ditty
  11. by   Lilith
    We do conscious sedation in our ER all of the time, and the nurse is responsible for the entire process - from pre-assessment, to drug administration, to recovery. Its actually quite a point of controversy in our ER, because the other nurses have to absorb the pt load for the nurse who is tied up, and the physicians always want to rush the process of recovery by using Narcan. God help us if we have more than one pt at a time who needs conscious sedaton! Its quite a problem. Anyone else experiencing these type of problems?
  12. by   debbyed
    We do conscious sedation in the ED for things like dislocated shoulders and recover them as well ..However...Once a patient leaves the ER for either an inpatient or outpatient procedure they are no longer ER patients and are never returned to the ER for either recovery or discharge.
  13. by   CMERN
    Guess I forgot to add (way back in the post) If we have consciuos sedation...for fx,shoulders, etc. we the R.N. are responsible for one on one. That being so we have to notify charge, and team leader so that our other 4 patients are covered and cared for whilr the attending nurse completes C.S. one on one.. ...and as you know if you get one C.S.,,, the ball is rolling and you'll probly end up sedating half the county before the shift is over...is there a name for THAT phenomenom????... ( other than sh*t magnet? :chuckle:
  14. by   CMERN
    o!!!wonderful Narcan..its half life is shorter than the meds used to put the patient under....well, actually Ive never used narcan in C.S. unless the pts in trouble.... Used it for Heroin O.D,s tho....Whew...one MAD MAN does wake up....makes me WANNA Conscious sedate 'em.......:spin: :roll
    Last edit by CMERN on Oct 10, '02

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