Conscious Sedation in the ER - page 3
I am interested in knowing what medications are used in your emergency department for conscious sedation. Do you use drugs such as Etomidate? Ketamine? Do these fall under your facility guidelines... Read More
Sep 7, '09Joined: May '08; Posts: 367; Likes: 134iv fentanyl and versed is what i've always used. both short acting enough to get a procedure done and good recovery, in addition to reversal/metabolism on the chance there is a problem.
etomidate could only be pushed by an md or crna b/c it is an anesthetic.Last edit by JStyles1 on Sep 7, '09
Sep 8, '09Occupation: RN Specialty: Pediatric Emergency Medicine/Trauma ; Joined: Nov '07; Posts: 28; Likes: 7I work in a very busy pediatric ER and we commonly use Ketamine and Versed for conscious sedation. Ketamine alone often has nasty side effects, using the versed helps to lesson the reactions (hallucinations, screaming, crying, etc).
We monitor VS q5min, utilize CO2 monitors, and have an attending physician present during induction. Although it's a lot of work for the nurses, it does mean less trips to the OR and an easier time for the children.
Sep 9, '09Occupation: staff RN - ED Specialty: 25 year(s) of experience in ED only ; From: US ; Joined: Sep '09; Posts: 86; Likes: 109We do conscious sedation fairly often. Adults with dislocations - Etomidate and Versed, sometimes adding Morphine or Dilaudid when there is a lot of discomfort with the reduction - sometimes just Etomidate alone because it clears the system quickly and the person is back awake very shortly. This is a 1:1 procedure and RN must be in the room continuously for one hour post-drug or , if the pt is still very sedated, until they are awake and back to baseline. It CAN be a very time-consuming procedure but most of the time, one hour and you are done and can leave the room. Children - don't do many of these - have used IM Ketamine and IM atropine but each child is unpredictable in how long this drug will stay in their system and ties up a nurse with continuous monitoring until they meet discharge criteria.