procedural sedation

  1. Are any of you out there involved in providing "conscious sedation," or "procedural sedation?"
    If so, in what setting?
    Any guidelines or tips from your experiences?
  2. Visit BRobison profile page

    About BRobison

    Joined: May '02; Posts: 50


  3. by   meandragonbrett
    I Know that Oral surgeons use it quite frequently. When I had it they gave me IV demerol and Versed to induce the sedation

  4. by   ageless
    we use it regularly...always use pulse ox, cardiac monitering, b/p etc...and make sure the narcan and flumazenil are available.
  5. by   BRobison
    are you using primarily fentanyl and versed?
    Any propofol, drip or otherwise?
    Do RNs in your facilty "do" the conscious sedation, or is it always CRNAs?
  6. by   ageless
    RNs certified to give conscious sedation give fentanyl, demerol, and versed in special procedures like endoscopy, line placements, epidurals injections, etc....I have given CS in the OR and in acute care settings. Hope this is helpful.
  7. by   meandragonbrett
    At my hospital RNs don't give CS only Anesthesia staff does. They mostly use a combination of ativan, Versed, and Demerol. No fent or propofol. They use it in the OR often and in our GI suites

  8. by   nilepoc
    In my ICU, we do all or our own CS. We use loads of versed, fentanyl, ativan, MSO4, and the occasional dose of ketamine. For kids, loads of ketamine and the occasional sufentanyl. We monitor all of our patients on monitors. Our hospital is currently instituting a CS team that will rove the hospital and give the CS. If I wasn't leaving for school, I would consider doing call for them.
  9. by   BRobison
    "ageless," when you say "certified," who does that certifying?
    Is it something done w/in your facility?
    I have been scouring the web for nurse practice acts and other info I can find, and I don't see anything addressing that, so am wondering if there is a national standard, or if it is done "facility by facility."
  10. by   ageless
    I am required to take an bi-annual class in the hospital's education department. No national standard that i know of.
  11. by   LilgirlRN
    We use conscious sedation all the time, all the paperwork is a pain in the butt. We use demerol, phenergan, versed unless the patient has an allergy to one of those. Ketamine is considered and anesthetic agent, so we aren't allowed to give it, if the doc is dead set on ketamine, anesthesia comes down to give it.
  12. by   alansmith52
    Our RN's do CS in the unit. usually versed Mso4 or propofol
  13. by   nrw350

    I am rather new to, but I may be able to shed some light here I hope. I have had this kind of sedation recently at my oral surgeon. To be honest, I have had 3 times with him. If I am not mistaken, a CRNA is the one who in charge of the administration of whatever they gave me to knock me out. But I do know of one visit where my oral surgeon administered the drugs himself. Each time, they had me positioned where I could not see my IV, or anyone was injecting anything into it. What makes me say the doctor himself administered it once is because he was nice enough to tell me just before he started the anesthesia, and after the administration he said something to the effect of "now, lets let that cook for a moment". I know that is an odd thing for a doctor to say, but I had asked them to take things slowly with me because of some bad experiences I had when I was younger.

    Is there anyway to know which drugs they used on me without asking them? I dont want to sound silly asking them what drugs they use. I dont know if this information would help, but in my opinion it took about 20 to 30 seconds for the anesthesia to take effect. I know the time may be off because those drugs alter one's perception. The anesthesia took effect gradually, but not bad at all. At first i just felt very much relaxed, then I noticed my eyes started to want to roll back in my head. Finally, I remember my vision going blurry, and then out I went.

    One reason I had a bad experience when I was younger I believe is because the anesthesia (general anesthesia for eye operations) took effect extremely quickly and I could not breathe before being completely asleep. That is why, I asked my oral surgeon to take his time. I also told him of my fears and bad experiences too. I think he made a note of it of in my file because since then all the nurses have been extraodinarily kind and careing. That in and of itself has been a tremendous help. I will be going back to my oral surgeon again to get some more work done in preparation for a denture. I have bad teeth as a result of bad genes and bad childhood habits.

    Sorry for the long winded post, but I really hope my information helps, and I can get some insight from everyone here.

  14. by   meandragonbrett
    They only way to find out is to look at your chart or ask the doctor. You won't sound silly asking what they are pushing. I'm a nosey pt. but the doctors and nurses seem to like that, sometimes. I want to know what they are giving me before they give it!


    BTW- Welcome to the board nick. Are you in the healthcare profession?j\w

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