Versed versus Ativan??

Nurses General Nursing

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Quick question. I have been a PICU RN for 3.5 years and travelled two years. I have seen different ways to treat different scenarios per hospital. My question is we had a child that was continuously seizing in a pentobarb coma. The RN caring for the child was treating with intermittent VERSED doses. I have always used Ativan. The versed seemed to be doing nothing. I think finally they did give Ativan in which the seizing stopped at least for the next few hours. Does anyone have an opinion on this scenario? I guess I have never used Versed to treat seizures.:idea:

Specializes in CNA, Surgical, Pediatrics, SDS, ER.

With the pedi seizures I've encountered in the ER we have used ativan but if we can't get them under control we ship them out.

As an anesthesiologist and critical care doctor, I can say that outside the OR, most health care professionals are not that familiar with versed. Versed acts within 2 minutes, while Ativan takes slightly longer, about 7 minutes. Both are benzo's and in the right dosages, equally effective in treatment of seizures. Ativan has the advantage in that it can be given IM if an iv is unavailable. However, if an IV is available, Versed is probably the better choice in that it acts sooner for an acute seizure, but as far as maintenance, remember that versed only lasts for 1 hour. Ativan's half-life is 15 hours so would probably be the better choice for prevention of future seizures. Otherwise, with Versed, you are going to have to give the same dose every hour on the hour. For this reason, Versed is mainly used for short term sedation in OR procedures, and is mainly an anesthetic drug. Versed also has retrograde amnesia, whereas Ativan and Valium have only anterograde amnesia.

Please understand that it isn't in anybody's best interest to extrapolate from your personal experience with a drug to other people. The drug works very well for many people millions of times a day at medical facilities across the world.

technically i agree with you hypo, but there are apparently more than a few persons with issues with this drug. If something exists with a better side effect profile, why not use it?....and why are some practioners insistent on its use?

Specializes in Critical Care.
technically i agree with you hypo, but there are apparently more than a few persons with issues with this drug. If something exists with a better side effect profile, why not use it?....and why are some practioners insistent on its use?

What drug would that be, morte?

Maybe propofol? Requires CRNA or MDA. Outside having one there, name another sedative with a short half-life ideal for conscious sedation in short procedures.

Fentanyl?

It's a great drug but the amount you'd need when used alone puts patients at risk for respiratory compromise.

Diazepam?

Similar side effect profile, not nearly as potent, and patients just love the way it burns when administered.

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