[Silktea3]

I am interested in knowing what medications are used in your emergency department for conscious sedation. Do you use drugs such as Etomidate? Ketamine? Do these fall under your facility guidelines for conscious sedation? Should these drugs be used in the ER?

They usually use versed with another agent maybe MSO4 or something short acting. The ER docs or whoever is doing the procedure usually orders the meds. We dont have anesthesia there.(If they need an ologist they shouldn't be done in the ER) Along with the consent forms, protocols for CS etc,etc.

[CTURNEY]

I WORK IN A FAIRLY BUSY EMERGENCY DEPT 43.000 PER YEAR. WE USE CONSCIOUS SEDATION WITH STRICT GUIDELINES INCLUDING DOCUMENTATION EVERY 5 MINUTES OF VS, MEDS, CARDIAC RATE AND RHYTHM, SAO2 AND LOC ACCORDING TO THE RAMSEY SCALE. WE HAVE DISCHARGE CRITERIA BASED ON THE ALDRETE SCALE, PAIN AND NAUSEA CONTROL AND STABLE VS INCLUDING SAO2. WE USE COMBINATIONS OF NARCOTICS AND VERSED AND/OR SUBLIMAZE. ON ANOTHER NOTE WE KEEP A RAPID SEQUENCE INTUBATION KIT IN WHICH WE STOCK ETOMIDATE, VERSED, SUCCINYLCHOLINE AS WELL AS OTHER DRUGS.WE DO NOT USE ETOMIDATE FOR CONSCIOUS SEDATION. WE USED TO HAVE A KETAMINE POLICY BUT WE FOUND IT WAS TOO UNPREDICTABLE. WE HAD PEDIATRIC PATIENTS WHO HAD POST-PROCEDURE STAYS OF 4 HOURS PLUS (IN THE ED) AFTER KETAMINE ADMINISTRATION. SOME OF THE OTHER ROUTES WE HAVE TRIED WITH PED PATIENTS HAVE INCLUDED INTRANASAL VERSED WITH VERY LIMITED SUCCESS.

[countessvonH]

To reply to your post. I ahve used etomadate for inutbation. I have used ketamine to sedate children, I am not a fan of it.
versed seems to be drug of choice for conscoius sedation. Remember ... don't risk your liscence if your not comfortable with any procedure. take care