Non anesthesia provider providing anesthesia

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I overheard an ED attending discussing a policy regarding the administration of propofol w/ an RN at work today. Apparently the policy states that propofol or any other medication may be administered to a non-intubated pt if an attending ED/Pulmonary physician is in the room. This would be done for a procedure ie: reduction of a fx....etc. I asked him why anesthesia personnel would not provide the anesthesia. He responded that the ED/Pulmonary physician is able to provide all services that anesthesia could. What do you guys think about this?

Propofol is most definitely a drug that needs to be respected and only used by trained providers. I remember having an intubated pt that was very agitated and trying to extubate herself....long story short I got a little happy and generous with the propofol and my BP went up while my pt's pressure plumeted!!!! Luckily it wore off quickly and all was well, but ever since then I have had a new respect for the drug.

One of our new Neurosurgeons likes for us to use propofol when he is inserting EVD's and camino's on our non-intubated pt's and I was very nervous the first time I did it because I was always told RN's were not allowed to bolus or infuse propofol on a pt with a non-secured airway. We spoke with pharmacy and administration and they said as long as an RRT was at bedside we could do it (respiratory intubates all of our pt's outside of OR).

I think people underestimate the drug because of its quick action, but I won't ever make my mistake again!! I will start CRNA school this fall and I am already gun shy because of my mistake, and I know they give a lot more propofol in the OR than I did....but I will be better trained and equipped with the knowledge to correct any hypotension and respiratory distress that I cause from anesthesia.

If you're in Georgia, you should rethink your position - as I recall, the Georgia BON has ruled that it is illegal for Georgia RN's to bolus propofol.

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Specializes in Neuro ICU.

Maybe I should have clarified myself....I don't practice this anymore....my point in posting was just to agree that it is not as safe as everyone seems to think for non-anesthesia providers to administer the drug- and don't worry, I have already re-thought my position and am no longer a staff RN....I am on a much needed 10 week break before I start CRNA school in August. I will be sure to pass this on to our administration though, because we had the same question when this doc wanted us to bolus propofol for EVD insertion on non-intubated pt's and we were told it was OK. Thanks for the info.

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Specializes in CRNA, ICU,ER,Cathlab, PACU.
This thread IS two years old, but ... once again:

Compare a person perfectly competent to administer Versed and to monitor and intervene with a sedation ... to a pilot perfectly competent in a Cessna light aircraft.

Then drop that pilot into the cockpit of an F-14.

That's the difference between Versed and propofol, and that's just how fast a person will get themselves -- actually get the PATIENT, of course -- in trouble.

!

I love flying / anesthesia comparisons. What happens when you drop an F-15 pilot into the cockpit of a cessna?

Food for thought.

:)

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Specializes in ICU-CVICU.
I love flying / anesthesia comparisons. What happens when you drop an F-15 pilot into the cockpit of a cessna?

Food for thought.

:)

My husband says it would be no problem. But he doesn't fly F-15's...just this old thing:heartbeat

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