propofol

We don't use it for CS. We use Versed here in Fort Worth.

I'm a traveler and have seen Propofol used for Concious Sedation. I am not fond of this. Usually I prefer Versed, or Ketamine (though ketamine does get squirrley sometimes.)

I actually will not do CS with Propofol. So, at my current facility, when I get a CS patient, if the MD wants to used it, the patient gets another nurse.

Edited to correct where I put Midazolam, instead of Prop. I guess its about time for sleep, just got off my 4th shift in a row of nights LOL.

Do a search and there is a great thread with a TON of info on pushing diprovan. I think that it is the GI Nurses section.

From what I understand, pushing Diprovan in bolus form is considered general anesthesia and is out of the scope practice of the RN and requires an anesthesiologist or CRNA, or it is in Texas anyway.

I won't push it either, even though in my state technically I could. Sure, I've got ACLS, but I couldn't put in an airway. I think it's foolish that any nurse who is not a CRNA is doing this. Unlike Versed or fentanyl, there's no reversal agent for propofol.

I push propofol in my ICU, but only on vented patients.

That's different; you've got an airway established.

Only docs push it in my dept in London. Interesting to see its also used for shoulders and hips, we use midaz for that :)

Propofol can only be used on intubated pts. at my facility, not for moderate sedation. For tubed/vented pts. we RNs can & sometimes do push a bolus in addition to the drip.

At our ER - the doctors can push it, RN's can't. You must be prepared to immediately intubate and be able to get an airway immediately. We only do it very occasionally for a hip or shoulder dislocation.

As a traveling ER nurse, that is generally the policy I have seen. In my current facility, there must be 2 MD's in the room when it is used. Even tho the RN is doing the monitoring and documentation, they want the MD doing the procedure to be backed up by one in case immediate intubation is needed. Sometimes it can get crowded in the room! We do use a lot of IV fentanyl and versed, with ketamine IM on kids a lot.

We are using it more and more for a slightly deeper concious sedation, works wonderously well.

So does Brevitol