oral sedation protocol

Nurses Medications

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Looking for a better oral sedation protocol for in office procedures. Currently prescribing demerol 50mg, promethazine 25mg, triazolam 0.25mg. Doesn't seem to be enough. Considered dilaudid instead of demerol. Anyone have experience with this? Suggestions?

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Specializes in CICU, Telemetry.

what about diazepam and benedryl? 50 of benedryl and 5-10mg diazepam.

Any specific procedures?

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mostly blephs and smartlipo ... in plastic surgeon's office.

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Specializes in CICU, Telemetry.

I just searched and you can get oral versed. I like Versed or Valium because of relatively short half lives and decent amnesia. It sounds like the types of procedures you're doing need more anxiolysis than pain control. You're dealing with a population of people who are so anxious about their looks that they're going under the knife. I'd want to make sure I knew what benzos/narcs they are on at home to know what kind of a tolerance they may have. Do you have access to that info ahead of time? It sounds like IV sedation isn't an option, but can you do nitrous oxide? That might be something nice to have on hand for when whatever they took orally pre-procedure isn't enough. I'm sure MD does not want to stop mid-procedure to give more oral meds and wait for them to kick in, so that might be something to look into for those cases.

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Specializes in GENERAL.

What's the procedure and what level of sedation does the nurse anesthetist deem appropriate? Shouldn't these decisions be made by the experts?

I am not liking what I am hearing only because there are too many nurses with too varied levels of experience with these drugs that are administering them with the good intention of helping the patient to be comfortable and relax.

That doesn't hold up in court.

This is just me but there are too many physicians out there from doctors to dentists using PO sedation and IV sedation who have limited experience with these drugs themselves who may not know what they are doing and are blinded by the profit motive, of course, with good intentions.

I know of two instances where practices giving IV sedation did not have crash carts. So when asked,"what do you do if someone needs resuscitation?" " Oh, we call 911."

Folks you really don't want to put yourself.in the position of becoming a dope's dope.

I'm reminded of the loss of Joan Rivers in that regard.

I'm wondering if they took the cell phone photo of her pre or post mortum. (Anesthesia)

Can you imagine what she would have to say about our tweedle dee and tweedle dum presidential candidates if she were alive.

Please excuse the the slightly off-subject comments. It is election day.

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What's the procedure and what level of sedation does the nurse anesthetist deem appropriate? Shouldn't these decisions be made by the experts…

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Yes, of course these decisions should be made by the experts, but I think that is the problem; I get the impression that they don't have a nurse anesthetist, and that the OP is being left to herself to determine what medications to use.

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Specializes in Transitional Nursing.

triazolam and ativan given SL worked beautifully for me. I don't remember a thing.

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