Using Propofol for sedation on vented pts? - page 5

Is Propofol used on vented patients? Since the half-life of Propofol is so short wouldn't it be more justified using a longer activing sedative? I assume that Propofol isn't used for long-term... Read More

  1. by   SLEEPERJC
    When orders for diprivan are written they may state titrate to sedation ramsey 2-3 so for example. If the bottle runs dry as occasionally it runs dry even to the best of us. a pt may need a bolus to get them calmed down, they are left at the maintenance dose of say 20ml/hr. Also they grow acostomed to a set rate and need to be adjusted sometimes first giving a bolus of say 3-5mL. Some pts are very sensitive to the diprivan and 5ml would sink there BP it's all at the nurses discretion.
    That's how it was shown to me when I came to the SICU.
  2. by   cardiacRN2006
    You might want to check with your BON about that...

    What people do and what's within our scope are two different things...
  3. by   montieICURN
    Propofol is milky white goodness. We aren't allowed to bolus it. Strict policies outline it's titration using a written starting rate, ie., 10 mcg/kg/min, and titrate to a rass of -2. We get the MD's to bolus (vented patients only) when needed, though they occasionally telepathically bolus while inserting a line. It's hard to multitask when you are in a sterile field.
  4. by   Lisa CCU RN
    Quote from montieICURN
    Propofol is milky white goodness. We aren't allowed to bolus it. Strict policies outline it's titration using a written starting rate, ie., 10 mcg/kg/min, and titrate to a rass of -2. We get the MD's to bolus (vented patients only) when needed, though they occasionally telepathically bolus while inserting a line. It's hard to multitask when you are in a sterile field.
    So nurses cannot bolus propofol?
  5. by   danamobile
    Quote from meandragonbrett
    What do you mean by diprivan having "less effects than versed for sedation?" Are you talking about the half life? Propofol is a general anesthetic and versed is a benzodiazepine. Propofol is going to cause MUCH more sedation than versed does.
    sorry i meant this: versed has more effects on blood pressure than propofol does (this is what the docs tell me anyways). but yes, propofol is much better for sedation all round. sorry i wrote that when i was tired and wasnt clear!
  6. by   danamobile
    Quote from CRNASOMEDAY25
    So nurses cannot bolus propofol?
    we are allowed to bolus propofol, but usually only during procedures or if a patient is really wild.
  7. by   montieICURN
    [quote=crnasomeday25;2357263]

    so nurses cannot bolus propofol?[/quote]

    correct. by our hospital policy, crna's or mds only.
  8. by   cardiacRN2006
    Quote from danamobile
    sorry i meant this: versed has more effects on blood pressure than propofol does (this is what the docs tell me anyways). but yes, propofol is much better for sedation all round. sorry i wrote that when i was tired and wasnt clear!
    Versed has more effects on BP than propofol???? I don't think so.

    Quote from danamobile
    we are allowed to bolus propofol, but usually only during procedures or if a patient is really wild.
    Not in my state! I will be explaining my actions in front of the BON if I'm caught doing so, in addition to losing my job.
  9. by   danamobile
    do employers have clear outlines for specialized drug administrations in most p laces of work? that scares me, seeing ill likely be working in the states next year!!!
  10. by   cardiacRN2006
    Is what you are asking, "How will I know what I can and can't do in each state?"
  11. by   danamobile
    Quote from cardiacRN2006
    Is what you are asking, "How will I know what I can and can't do in each state?"
    i think so lol or if the information is readily available as well..
  12. by   cardiacRN2006
    You know....I don't know!
    It's easier for me, because I learned what I can and can't do in nursing school. I can go to my BON's website and look up my scope of practice and nurse practice act. I can only assume that you can do the same for each state...?
  13. by   Indy
    Quote from montieICURN
    Propofol is milky white goodness. We aren't allowed to bolus it. Strict policies outline it's titration using a written starting rate, ie., 10 mcg/kg/min, and titrate to a rass of -2. We get the MD's to bolus (vented patients only) when needed, though they occasionally telepathically bolus while inserting a line. It's hard to multitask when you are in a sterile field.
    Wow! Telepathy? If I could do telepathy I wouldn't need a second set of hands during foley insertions or dressing changes... that would be so nice!

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