RN Propofol/Vecuronium IV push, is it ever legal???

[jamesk78]

I found some old threads from like 2005 on this topic and thought the responses might not be accurate in 2012. I know the Maryland scope of practice states an RN is not allowed to bolus Propofol, but is it legal to push at the direction of an MD while they are standing in the room?

Also, is it acceptable for an RN to independently push Vecuronium per a prescribed order?

Any help in answering these questions or finding them would be greatly appreciated.

[ProgressiveActivist, BSN, RN]

If your pt is INTUBATED and SEDATED it is acceptable for the RN to push 10 mg of Vencuronium. This may be necessary for line placement, or control of shivering during therapeutic hypothermia. It is also a rapid sequence intubation drug given in place of the 1mg/kg of succhinylcholine.

It is acceptable for the RN to push 10 mg of propofol ONLY DURING RAPID SEQUENCE INTUBATION under the direct supervision of the MD who is intubating that pt.

[Esme12, ASN, BSN, RN]

I think you iwll find what you need here.....google is your friend.

http://sedationcertification.com/uploads/states/Maryland.pdf

[jamesk78]

Thanks for the info. I was afraid of the "during rapid intubation" clause. I've had a number of MD's instruct me to bolus a small dose of Propofol to intubated and nonintubated pts for bedside procedures, just got cited for it and a little irritated I was ignorant of my scope of practice. Was hoping there was some clause stating that it was ok under the direct supervision of the MD performning the procedure.

[jamesk78]

Yea, my manager handed me that document as she wrote me up, however at the very end of it it stated that under certain conditions it is within the scope of practice of an RN to dose and monitor pt for procedural sedation. That info is supposedly outlined in a separate declaratory ruling "Registered Nurse Administration of Procedural Sedation for Operative, Invasive, and Diagnostic Procedures and for Episodic Treatmewnt or Therapies for the Adult and Pediatric Patient" and I can't seem to locate it.

[Esme12, ASN, BSN, RN]

Isn' that what I posted??? Page 2 mid page.....it starts with "The Board Ruling....."

[umcRN, BSN, RN]

I've never given propofol on my unit but I routinely give vec & roc to my INTUBATED patients, we frequently have little cardiac babies/kiddos whose sick heart and lungs just cannot tolerate ANY movements, we also like to keep our 2 year olds with open chests pretty paralyzed

[detroitdano]

Why Propofol for nonintubated bedside procedures? The only time we ever see Propofol pushed in my hospital is when anesthesia is intubating someone, other than that, it's rarely used as IVP. Our go-to is Versed and Fentanyl for procedures.