Is this just a regional problem, or are other hospitals having a hard time getting an adequate supply of propofol? Ours is mostly on lockdown and what we have is allocated to the OR. They won't let the ICU doctors order it for ventilated patients because of the shortage. It's been a few months, and it's gotten really tiresome. The fent, versed, ativan, precedex gtts (whatever) just aren't as good. I think that our unplanned extubations have gone up as well.
meandragonbrett 2,438 Posts Jul 21, 2010 Propofol ShortageYes, there is a nationwide shortage.We are using Propoven 1%
CNL2B 516 Posts Specializes in multispecialty ICU, SICU including CV. Has 10 years experience. Jul 21, 2010 I've never used Propoven. I don't think anybody knows about it up here.Oh, I looked -- non-American propofol. I work for the Feds. I bet we won't import it.
CrufflerJJ, RN 1 Article; 1,023 Posts Specializes in ICU. Has 5 years experience. Jul 21, 2010 I think that our unplanned extubations have gone up as well."Unplanned extubations"? I prefer to call them patient-directed spontaneous breathing trials.I agree that the propofol substitutes just don't seem to work as well as the white stuff. You can crank & crank up the drip rates on versed/fentanyl, and still end up with a pt fighting against soft restraints and extubating themselves (usually happening at shift change).I've not seen Propoven in my ICU. We still have a very limited supply of 100ml Propofol & Diprivan bottles. Not sure if the Propoven is being used in other units. I suspect that it may be, since I helped out with a PEG placement last week, and one of the endo nurses mentioned that the new version of propofol contained peanut oil.
meandragonbrett 2,438 Posts Jul 21, 2010 Propoven 1% is dosed the same way as Propofol and is white but it is a bit different chemically.
lkwashington 557 Posts Specializes in Tele, ICU, ED, Nurse Instructor,. Has 4 years experience. Jul 21, 2010 We did have a problem about 2 weeks ago. We have some now. We were using some of the same drugs mention in a previous post. No they are not as affective. You may have to think about the patient who a renal and heart failure...the concentration is very important.
APRN., DNP, RN, APRN, NP 995 Posts Specializes in Family Practice, Mental Health. Has 32 years experience. Jul 21, 2010 Propofol is used sparingly in our ICU. We have switched to Precedex.
NocturneRN 168 Posts Specializes in ER, cardiac, addictions. Has 30 years experience. Jul 21, 2010 Is this just a regional problem, or are other hospitals having a hard time getting an adequate supply of propofol? Ours is mostly on lockdown and what we have is allocated to the OR. They won't let the ICU doctors order it for ventilated patients because of the shortage. It's been a few months, and it's gotten really tiresome. The fent, versed, ativan, precedex gtts (whatever) just aren't as good. I think that our unplanned extubations have gone up as well.I'm from the midwest, and we have a propofol shortage here, too. We're also no longer getting D50 in the prefilled syringes----now it comes in a bottle and has to be drawn up. Ditto for prefilled epinephrine syringes. And, at various times, we've had trouble getting Dilaudid in the Carpuject cartridges. Seems like there's always a shortage of one drug or another lately.
esrun00 110 Posts Specializes in cardiac, oncology. Has 22 years experience. Jul 21, 2010 Just yesterday got a work email stating a national shortage of epi and that the code carts would only be stocked with 3-4 syringes and that the docs are being instructed to use vasopressin instead.
bilingueRN 25 Posts Specializes in Critical Care, ED. Has 2 years experience. Jul 21, 2010 Interesting about the amps of Epi. Do you think that the docs are OK with that since in the ACLS algorithm you can only use vasopressin once? (not that the docs can't use it more, but with the new interns using their little flow sheet cards, it might get interesting)In our unit we are almost exclusively using the Versed/Fentanyl combo that works pretty poorly IMHO. We have a very limited amount of propofol in the pyxis; it just sits there daring us to use it through the clear doors!
CNL2B 516 Posts Specializes in multispecialty ICU, SICU including CV. Has 10 years experience. Jul 21, 2010 In our unit we are almost exclusively using the Versed/Fentanyl combo that works pretty poorly IMHO. We have a very limited amount of propofol in the pyxis; it just sits there daring us to use it through the clear doors!If we had it, we would use it ... they pulled it off our shelves, and pharmacy won't dispense.
saltwaterstat 98 Posts Specializes in pedies and er. Has 20 years experience. Jul 21, 2010 well, shoot, dont I feel just peachy now. not out there working (currently working on my pre-reqs for lpn to bsn, UGH), so I didnt know there was a shortage. someone very near n dear to my heart (lol) is having a "procedure" this friday, supposedly under the "please knock me out cold" comfort of this drug. crap crap crap.hmmmm, should be interesting to see what will actually be used. I think this falls under "nurses & doctors can be the worst patients".
