Versed use?

1. At a Recent course I attended (S.T.A.B.L.E. Instructor) the instructor stated that VERSED is no longer recommended for use in Neonates, (something to do with Increased risk of IVH).
   My Unit uses it very often, in fact it is the drug of choice (combined with Fentanyl) for most intubated neonates. We do sometimes use Ativan in place of Versed.
   I am wondering what your units policy is, and if you can point me to any specific references/consensus statements that support this claim.
   
   Thanks....
   
   Greg
2. 

   About Navy1Nurse

   Joined: Oct '01; Posts: 25; Likes: 2
   RN
   Specialty: 14 year(s) of experience in NICU

   19 Comments

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3. 
   Jan 8, '03

   Occupation: NICU RN Joined: Oct '00; Posts: 2,537; Likes: 369

   News to me. Just used continuous and bolus doses on a neonate yesterday.Did the instructor have any research to back this up?
4. 
   Jan 8, '03

   Occupation: RN Joined: Mar '01; Posts: 999; Likes: 2

   We use Versed more frequently than Ativan. I have never heard that it increases the risk for IVH.
   
   Heather
5. 
   Jan 8, '03

   Occupation: Re-retired Specialty: 42 year(s) of experience in NICU, Infection Control ; From: CA, US ; Joined: Dec '00; Posts: 12,419; Likes: 3,760

   We hardly EVER use Versed, always Ativan.
6. 
   Jan 9, '03

   Occupation: once a manager, now a staff nurse, preceptor, educator and practice member Specialty: 30 year(s) of experience in NICU, PICU, PACU ; From: FAM ; Joined: Mar '01; Posts: 2,797; Likes: 3,172

   I haven't heard that...I'll have to ask at work today. We mostly use Fent. and MSO4. We use Versed on our big PPHN kids a lot.
7. 
   Jan 9, '03

   Occupation: Registered Nurse Joined: May '01; Posts: 204; Likes: 8

   Ive seen the versed used and the MSO4 as well I have not seen Ativan as much. The most common used drugs of choice on the vented neonates are Versed, Fentanyl, and Ciss...which are used on our unit.............:roll
8. 
   Jan 10, '03

   Occupation: once a manager, now a staff nurse, preceptor, educator and practice member Specialty: 30 year(s) of experience in NICU, PICU, PACU ; From: FAM ; Joined: Mar '01; Posts: 2,797; Likes: 3,172

   I asked one of our attendings who had studies that Versed can cause seizures in small babies. It can cause clonic movements of the extremities. I do now remember seeing this on a couple of kids, but like I said, it has been so long since I used it on a small baby I kinda forgot! I would suppose that a seizure could lead to IVH if it were severe enough, but it would have to be pretty bad!
9. 
   Jan 10, '03

   Occupation: Level III NICU Specialty: NICU ; From: US ; Joined: Oct '00; Posts: 1,605; Likes: 929

   Our drug of choice for intubated preemies and terms kids is Ativan. Unstable babies might also have a PRN Fentanyl or MS order. Really unstable babies will get a Fentanyl drip.
   
   Almost NEVER see Versed. I've seen a Versed drip only a few times in 2+ years and I can't say why they were giving Versed (wasn't my pt). I do remember that the babies they were using it on were MAS PPHN HFOV babies.
10. 
    Jan 10, '03

    Occupation: RN Joined: Aug '02; Posts: 27

    I have also heard that Versed can cause IVH. My unit uses fentanyl & nembutal (alternating) for most of our babies.
11. 
    Jan 10, '03

    Occupation: RN Specialty: 14 year(s) of experience in NICU ; Joined: Oct '01; Posts: 25; Likes: 2

    Thanks for the replies!... I will research this further and talk to our attendings..
12. 
    Jan 10, '03

    Occupation: Registered Nurse Joined: May '01; Posts: 204; Likes: 8

    wow that is why i love this BB. I will definitely ask my preceptor about the Versed when I return to work.
13. 
    Jan 12, '03

    Occupation: Phlebotomist/CNA/Nursing Student Joined: Apr '01; Posts: 44

    What is IVH?
14. 
    Jan 12, '03

    Occupation: rn-er,nicu Specialty: 12 year(s) of experience in ER, NICU, NSY and some other stuff ; Joined: Aug '00; Posts: 1,939; Likes: 232

    My husband gave me a summary from the Cochran library that looked at 2 small studies regarding versed. In one of the studies they cited a higher incidence of IVH, longer stays and even death.
    Was news to me too since we used it in one of the units I used to work in.

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