clarkw12

Correct that was from a text book but it was referenced in a text book from evidence-based practice from a committee structure and expert panel who researched sedation. The book referenced this evidence based work..... Vender, J. S., Szokol, J. W., Murphy, G. S., & Nitsun, M. (2004). Sedation, analgesia, and neuromuscular blockade in sepsis: An evidence-based review. Critical Care Medicine, 32(Suppl.), S554-S561.

"How much sedation is given, and for how long, is important in determining patient outcome as both over and under-sedation can have potentially deleterious consequences. Over-sedation can increase time on ventilatory support and prolong ICU duration of stay. Under-sedation can cause hyper-catabolism, immunosupression, hypercoagulability, and increased sympathetic activity.1 Haemodynamic responses as a measure of sedation are unreliable in the critically ill patient, hence the need for formal sedation scoring." Rowe, K.& Fletcher, S. (2008). Sedation in the intensive care unit. Continuing Education in Anaesthesia, Critical Care & Pain. 8(2), 50-55.

Patients who require mechanical ventilation commonly require sedation and analgesia. Neuromuscular blockade is also needed for some patients. Although pharmacological support is an important intervention, administration of analgesics, sedatives, and neuromuscular blockade often results in prolonged mechanical ventilation and related consequences such as ventilator-associated pneumonia. Sole, M.L., Klein, D.G., & Moseley, M.J. (2009). Introduction to critical care cursing (5th ed.). St. Louis, MO: Elsevier.

are you kidding me, I never said I thought it SHOULD be used for the convenience of nurses. I never said sedation SHOULD NOT be used. I am just bringing up the point that sedation is sometimes over used and when it is it can cause patients to have longer hospital stays. Under-sedation can also be a problem for the patient. Both sides need to be looked at and weighed in order to get the appropriate care for patients, thus the purpose of this forum. I work in an ICU and the focus here is using the least amount of sedation possible for the benefit of patients recovery time. I appreciate all the constructive and informative remarks.

I am a student and just wanted to see what people have seen/experienced in the use of sedation with ventilators. In our class we have discussed that it is concerning how sedation is sometimes used and that it can actually lengthen the time that patients are on ventilation.

That is one reason I posted the question, in our class it has been discussed and I have also seen, that sometimes healthcare doesn't necessarily do what is best for the patient in the long term but instead takes the easy/convenient rout. I understand that nursing is not about making the job easier for the staff, but that doesn't change the fact that nurses might use the medication to calm their patient down so they don't have to constantly be at the patients bedside calming them down. In some instances that may be for the long term benefit of the patient, but I am sure it has been used just to make life easier on staff. I am not suggesting that that is right, I just wanted dialog and to see what people have seen.

I was just wondering what everyone here thinks about the use of propofol for pateints on ventilators. I can see both an upside and downside to using this medication with patients on ventilators. On the one hand it makes the nurses job much easier as the patient is relaxed and not pulling at the ventilator all the time, also posibly helping with patient safety. But on the other hand it seems like it might take the patient much longer to wean off the venilator and increase the likelyhood of hospital acquired pneumonia. What do you think? Let me know what you have experienced?