Propofol

Specialties Gastroenterology

Published

I wondered if anyone of you as RN's

use propofol? Only the anesthesia

people are using it. When anesthesia

is used they use propofol. We as Rn's are pushing the Demerol, Versed, Morpheine, Nubain,elc.for conscious sedation. We

are not "allowed " to push propofol or

really any Fentanyl. Is this typical?

Or are we as RN's being overruled or

not allowed to push such drugs..........???

We usually use Demerol and Versed.

but propofol requires a nurse anesthestist or an anesthesiologist.

Is this common????

kewlnurse

427 Posts

We can use it in ccu areas, fentanyl also. Floor nurses aren't allowed to push much of anything, 'cept most narcs.

EndoRN

79 Posts

We don't do our own sedation where I work. Anesthesia does it. But when I worked at the hospital we were NOT allowed to push it. Only Demerol/Versed/Droperidol...........the usual stuff. :)

I just atttended a workshop for IVCS. It was pretty interesting. They said Propofol can be given by any RN. So it must just be up to the hospital's policy where it can be pushed. Only in ICU...or whatever.

Amy :)

PhantomRN

299 Posts

We run Propofol as well in our unit.

lmbv55

5 Posts

Our anesthesia staff gives the propofol. web use demerol, versed, MS, fentanyl. I personally don't want to give it, it's deeper than conscious sedation and some times conscious sedation goes too deep for me.

ButtRN

5 Posts

Only Anesthesia administers Propofol thankfully! I think it would be a huge mistake to allow any RN to PUSH Propofol!!!!! The liabilities would be huge and we certainly do not make enough money to cover the malpractice! Did you ever watch Propofol given and watch how some people completely go out and need constant airway support? A Propofol drip in an ICU is one thing as it is a slow drip and many of the patients are already intubated! The implications are huge! Much more so than involved with Fentanyl, which can be given safely with just a little care! Not all RN's are that careful. I really hope and pray that Propofol will only be given by anesthesia, as their only responsibility in the case is the patient, nothing else. A far cry from what we who administer concious sedation are required in any given case! It's the best drug ever in my opinion but something for Anesthesia, the same as General Anesthesia!

patsue53

41 Posts

Only anesthesia administers Propofol in our endo lab and like ButtRN I'm more than thankful! We typically use versed and demerol...occasionally fentanyl...and morphine or nubain if the patient is allergic to demerol. Propofol is very powerful. It's a great drug but I'll let the Anesthesiologists take the liability thanks! :)

Endo Diva

9 Posts

:zzzzz We use Demerol and Versed mostly! I was at an ERCP conference in Milwaukee and there does not appear to be a push for RNs to give Propofol. Too many issues and like said deeper sedation than we are trained to manage as RNs. We are not paid enough money to be responsible for deeper sedation!

LibraSun

23 Posts

Holy Cow!! Have none of you guys taken ACLS? I would LOVE to be able to give Propofol. The patient wakes up in seconds. It has a half life of 1.8 minutes!!! I would rather bag a pt for 1.8 minutes than give an 85 y/o 85 lb lady 125mcg of fent and 5 mg of versed!!!!!! Then have to reverse her!

I understand there is an Endo lab in southern Oregon that trains RNs in GI to administer propofol---would love to go there!!!

When I worked in the Midwest as a recovery room nurse we had a procedure room for ECTs, and the Drs started the propofol and we managed it during and post procedure. I NEVER had a problem with airway (if that is the concern)--only with people waking up TOO FAST!

Don't sell yourself too short, RNs keep people alive all the time. All the nurses in our GI lab have ICU/ER experience and ACLS. We need to expand our expertise, not limit it. As long as we are appropriately trained and supervised by an MD, there is no reason to fear administering a medication that enhances the patients comfort and safety during procedures.

ENDOgal

12 Posts

WE don't use Propofol either.

We use mostly versed, sublimaze, and occasionally (for 1 doc) demerol.

yoga crna

530 Posts

If you want to administer propofol, go to anesthesia school. It is is a potent anesthetic that can cause cardiac depression, hypotension, respiratory depression and loss of a protective airway. I give it every day and am always impressed with its unpredictablity and potency. Also, it is listed as an anesthetic and should only be given by professional anesthetists. See the package insert. It would be interesting to see how a jury would respond to an non-anesthetist administering an anesthetic.

Sorry guys, I feel stronly about this issue.

YogaCRNA

shoelace

49 Posts

I have to agree somewhat with YogaCRNA. I work in ICU and give Propofol ONLY to intubated patients who are continuously monitored. I don't think it's appropriate for concious sedation. An 85yo 85lb patient can possibly have just as hard of a time clearing Propofol as anything else. I'm all for expanding our expertise, but opening ourselves up to liability is not cool.

I do NOT mean to imply that I don't think that appropriately trained RN's shouldn't give Propofol. I've used it for years, but you would not EVER catch me giving it to a patient for concious sedation who was not intubated.

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