vcug's with sedation

frann · Apr 26, 2003

Am a little frustrated here. A few of us in our dept do vcug's. if the child needs sedation, then the primary doctor must supply us with a order. They never come with sedation orders!! I'm now will start turning them away or do it without sedation. It usually takes Dr.s office 1 hour to getorder faxed to us. Last time it took 3 hours! And the doctor still would not give us a order. Dr. felt uncomfortable ordering sedation with us. Did not feel there was anyone to monitor the pt. Hello, we have a policy set up and I am a RN. Pt would have been monitored throughout the procedure.

This doctor has ordered sedation with us before, I guess she just forget we had nurses over here!

Pt waited forever. Was forced to try it without. I got kicked in the boob. She's coming back next week and I'm off that day!!!!

RadRN2 · Apr 28, 2003

Frann, actually we prefer to do VCUG's WITHOUT sedation because: 1) we (RN's and Rad's) feel that sedation is unnecessary as catheterization is "usually" pretty quick, 2) sedation creates a risk to the pt, 3) the child may be unable to void when needed during the exam, and 4) the child must stay for a lengthy recovery time after the exam instead of just being able to leave. Once in awhile we do sedate if the parent(s) are insistent, if there is a history of sexual abuse, or a few various other reasons that sedation is preferable. In that case, we get our sedation orders from one of our Rads, since they are responsible anyway, and we do have standing orders for oral Versed or Chloral Hydrate that we most often use. If you check the ARNA website, you'll see that sedation for VCUG is an often discussed subject with the general consensus being that sedation is undesirable. There is alot of discussion, however, on pediatric sedation in general, with alot of nurses posting their facility's protocols. Would that help?

RadRN2 · Apr 28, 2003

Frann, actually we prefer to do VCUG's WITHOUT sedation because: 1) we (RN's and Rad's) feel that sedation is unnecessary as catheterization is "usually" pretty quick, 2) sedation creates a risk to the pt, 3) the child may be unable to void when needed during the exam, and 4) the child must stay for a lengthy recovery time after the exam instead of just being able to leave. Once in awhile we do sedate if the parent(s) are insistent, if there is a history of sexual abuse, or a few various other reasons that sedation is preferable. In that case, we get our sedation orders from one of our Rads, since they are responsible anyway, and we do have standing orders for oral Versed or Chloral Hydrate that we most often use. If you check the ARNA website, you'll see that sedation for VCUG is an often discussed subject with the general consensus being that sedation is undesirable. There is alot of discussion, however, on pediatric sedation in general, with alot of nurses posting their facility's protocols. Would that help?