conscious sedation reversals

[milkers]

For Versed and Fentanyl reversal meds (narcan and flumazenil) what types of patients would we never use these for?

For Flumazenil is it in patients with seizure risks?

Thanks :)

Also...how common is it in GI for a nurse to be administering conscious sedation w/o the doctors orders 1st entered. I am told that the physician enters the orders for the dosage after he sees what we gave and their is a very trusting MD/RN relationship (which I don't feel comfortable with).

[RNsRWe, ASN, RN]

For Versed and Fentanyl reversal meds (narcan and flumazenil) what types of patients would we never use these for?

For Flumazenil is it in patients with seizure risks?

We only use Demerol and Versed in patients who are for some reason not getting Propofol (but it's pretty rare). Haven't had a need for Narcan, but also haven't had any contraindications for it either.

Also...how common is it in GI for a nurse to be administering conscious sedation w/o the doctors orders 1st entered. I am told that the physician enters the orders for the dosage after he sees what we gave and their is a very trusting MD/RN relationship (which I don't feel comfortable with).

Seriously? Absolutely not. The procedure room RN looks at MD, asks "how much do you want?" and MD tells RN what to administer. There is NO "let's see how much the RN uses to knock 'em out"!

Trusting relationship? You mean the MD trusts the RN to not kill his patient, and the RN trusts the MD to not throw him or her under the bus if something goes wrong?

If anyone is doing this, well....that's on them.