Fentanyl

[Chuckie]

This

[sunnybrook83]

Ketamine is great for putting kids under, but boy watch them when they are waking. Ketamine is related to PCP and can cause hallucinations and horrible dreams. We always put those kids in our isolation room with the door shut and lights down until we were sure they were awake- if they are hallucinating the different sounds can really set them off!!

[thisnurse]

according to my drug books, versed is conscious sedation. i will never give that on my unit again and i will certainly bring this up with my manager.

that tube should never have been put in at bedside in the first place.

[AZRadRN]

I use Fentanyl and Versed almost exclusively for conscious sedation. Have to agree- Prefer Fentanyl over MSO4 (much easier to titrate, fewer s/e). IV Versed is definitely conscious sedation. In most places, only critical care areas are allowed to administer it. At my previous job, we used PO Xanax and IM Fentanyl for pts undergoing some invasive procedures. It worked great! Not conscious sedation (no IV meds) and didn't require conscious sedation monitoring, just baseline and post-procedure VS/discharge (these were mainly outpatients). :p

[LilgirlRN, ADN, RN]

The only time I've had fentanyl was just before I had my appendix out, so I wasn't awake long enough to tell you if it worked for me. Judging from the patients that come to the ER, I would have to say the patches don't work very well...many patients come in with them plastered allover their chest and they are still carrying on something awful.

[nurs4kids]

We use versed on pediatric patients in the 7-12 age group, not just on the older kids (teens). It works well on the 7-12 age group. Why do you not use it on that group?? We also administer kids IV Versed PO for preop anti-anxiety; works wonderful (tastes awful!). Anyone else do this??

Our guidelines for Versed Conscious sedation for procedures in:

CHILDREN

Oral: 0.5-0.75mg/kg/dose

IV: 0.05-0.1mg/kg/dose

ADOLESCENTS >12yrs0.5-2mg/dose over 2 minutes every 2-3 minutes until effect achieved

Maximum dosage: Oral: 15mg/dose

IV: 2mg/dose

[radnurse2001]

I have found IV versed to cause hyperactivity in children. We use .1mg /kg max. I have used it a few times. Only 2 times did it work, the others either became hyperactive or failed. I had one go into laryngospasm---now a little gun shy. Any other suggestions would be helpful nurse4kids.

Anne

By the way, I do use oral versed for VoidingCystoUretherograms. It is a crap shoot. works 50/50.

[LilgirlRN, ADN, RN]

We use Demerol, Phenergan and Versed for conscious sedation on adults, works well. We don't do many peds (thank God), Children's Hospital is not far from our location. We used ketamine a few times and then someone decided to check with the Board of Nursing..RN's can't give the stuff, its considered an anesthetic, so now if we hasve a bone to set on a child or whatever, most of the time its done in surgery. YAY!!

[kaycee]

We also use po Versed in the ER for very hyper kids that need mild sedation for sutures, especially in a hard to suture area like the tongue. Usually works well.

[panda_181]

Just a question...you guys say that you would never recommend certain types of drugs for certain patients...doesn't it depend on the patient? Some of you say that Fentanyl works for CA patients, some of you say it doesn't work. I would guess that you would have to try for each individual patient. Pain is different for everyone, right? Now, I know I don't know much about this, still being a student and all, but this is just my "educated guess"...

Amanda :)