Re: Propofol
Bias is not necessarily a bad thing as originalred seems to imply, it often is something that a savvy nurse gets through experience. All meds that are manufactured and then approved by the FDA are not equal in terms of their usage, administration, effect, and many other aspects. Saying this I sincerely hope I`m not telling anyone anything new here.
Of drugs in the you better watch your Hinney catagory Propofol is one of the worst, simply for the reason that it is usually ordered by a Dr, that doesn`t really want "conscious sedation". What the Dr usually wants is deep sedation to borderline anesthesia, to simplify his/her procedure, and propofol can do this without a doubt.
Unfortunately unless you are an RN, that is also a CRNA, you are not licensed to administer this drug as the Dr usually wants it. Using this drug for "conscious sedation" whilst sticking a garden hose down a persons throat seldom works as "conscious sedation", this isn`t my bias, just a statement made by my GI Dr, whose staff used a very smooth mix of Versed, and Fentanyl during my UGI, on waking I didn`t remember squat, and very quickly recovered, he told me this was par for the course. I had asked earlier about propofol, and he just shook his head saying "not in our lab".
My Bias comes from working with the Mothers Milk, and constantly bagging people, and often starting fluid boluses, which to tell truth the pts, rarely could tolerate.
All I can say is that after years of fooling with "conscious sedation" I prefer Versed, with Fentanyl, or MS. It works, never did I have to bag anyone, and found hypotension not to be a problem, as it is almost every time with Propofol. Fortunately in the ERs where I worked the Drs were very good about letting you use whatever you were comfortable with. I might also point out it wasn`t just my Bias evidently, as given the choice to a person everyone used Versed, with either Fentanyl, or MS.
Unfortunately during my time in the Cath lab, which I dearly loved, but quit over the use of Propofol, 2 of the Drs insisted on using it, and the worst part is they were EP guys, long procedures abound, and I certainly acted as an anesthesiologist more times than I care to remember, because these pts were not anywhere near conscious. Bias YES, I eventually got smarter I guess, as after thinking about what I was doing, I finally got out.
The goal: "CONSCIOUS SEDATION", propofol isn`t the correct drug.
The facts: Just read the pkg insert.
OhERRN1984
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