Concious Sedation...on your unit??

Babygrand · Aug 9, 2003

Thanks.. I appreciate your input.

One of the concerns we have is when do you "have" to have a cardiac monitor and when is it not necessary. Patients with cardiovascular disease, and those you expect to see arrythmias with is advised, however, that doesn't mean that the patient couldn't still crash. Will it then be the doctor's discretion??

Karen

mattsmom81 · Aug 28, 2003

Our conscious sedation drugs are Versed and

Diprivan. If they are used during any kind of procedure ie endoscopy or bronch, then we follow conscious sedation protocols, special documentaion form, etc.

When we give these drugs routinely for a vent patient, we do not document on the conscious sedation record, we have the pulmonary group's protocol to follow.

Usually conscious sedation procedures occur in the critical care areas. Our stepdown charge nurses have been trained in consc. sedation protocols and in a pinch can do this IF a doc insists on a scope etc. on the stepdown. We have a few portable Passport monitors on stepdown for assessing sats, respirations, rhythms and freq BP...all necessary for conscious sedation.

Usually these conscious sedations for procedures occur in our ICU though, if not in special procedures lab, ER, OR, etc. For safety.

An RN (or anesthesia provider) trained in conscious sedation is the only staff allowed to do this in my facility.

I would never administer Versed or Diprivan without continuous monitoring mentioned above. Respiratory depression can occur too quickly. One must be ready to intervene promptly.

txdolphin · Dec 12, 2003

Do any of the Hopsitals you all work for allow LVNs to monitor concious sedation patients? No initial assessment, no initation, monitoring only. (This is assuming they are trained and competence assessed.)

Geeg · Dec 18, 2003

I resent CS duties being dumped on the ICU RN, who has more than one pt. I think that pt undergoing CS should be a 1:1 during and for an appropriate time interval after. Otherwise, let anesthesia do it, and of course, BILL FOR IT. Hospitals: MORE duties, LESS cash!!!

kc ccurn · Dec 29, 2003

In our hospital, CS can be done on the floor only if there is an ACLS certified RN (no LPN or LVN's) who can stay with the patient throughout and afterwards to recover the pt. There MUST be cardiac monitor, pulse ox monitor, O2, ambu bag and cor cart nearby. Many times if a doc needs to do conscious sedation on a patient, they will check with the ICU charge nurse and use our treatment room that has all that stuff for the procedure.

I would not let my patient receive CS without resuscitative equipment available with a trained RN there. Period!