Propofol Sedation Guideline



Propofol Sedation Chart

ROYAL DEVON & EXETER EMERGENCY DEPARTMENT

Sedating propofol may only be performed by accredited ED doctors

| |Date: |

| |Dr performing sedation: |

|PATIENT DETAILS LABEL |Dr performing procedure: |

| |Nurse present: |

• An accredited practitioner must be present for sedation purposes. An additional doctor is required to perform the procedure. An ED nurse should also be present.

|Weight of patient: |Anaesthetic problems: |

|Allergies: |Last ate & drank (time): |

|Medications: |Past medical / surgical history: |

|Checklist for nurses and doctors performing procedures under IV sedation |

| |

|Pre-procedure |

| |

|Consider propofol sedation for joint relocation or cardioversion |

|Perform an airway assessment (are you confident of being able to ventilate this patient if necessary) |

|Consider the use of nitrous oxide / oxygen mixer as an alternative or addition to IV sedation with midazolam. |

|Consider risk/benefit of sedation for at risk patients: the elderly, the morbidly obese and those with concomitant medical disease including: |

|cerebrovascular disease, heart disease, lung disease, renal disease, liver disease and jaundice, bleeding disorders, acute gastrointestinal bleeding, |

|shock, anaemia and concomitant drug therapy |

|Obtain written consent for the procedure |

|Estimate patient weight (ideally weigh the patient) |

|Move patient to the resuscitation room |

|Cannulate patient |

|Preparation of drugs. Check and record observations prior to procedure |

|Equipment check: suction, pillow available, airway equipment |

|FASTING |

|Record the patient’s fasting state. Fasting is a consideration but not a necessity for sedation |

|THE procedure |

| |

|Pre-oxygenate the patient with an Fi02 of 1·0 for 3 minutes prior to sedation. Alternatively get the patient to perform five vital capacity breaths |

|Give 1mg/kg IV of propofol as a bolus (though less for DC cardioversion procedures) |

|Continue letting the patient breath on Fi02 of 1.0 |

|Perform the procedure at 60 seconds |

|Give incremental top ups of 0·5mg/kg of propofol prn |

|Time(s) |

|Post procedure |

| |

|The patient should not leave Resus/ 1:1 nursing until spontaneously alert and talking |

|Mobilise with aid initially |

|Discharge criteria: |

|Observations back to, or better than baseline | | |

|Pain controlled | | |

|Complete the propofol registry on the Resus room computer | | |

| |

|Discharge criteria met: Yes / No |

|Doctors Signature: Doctors Name: Date: |

| |

|Nurses Signature: Nurses Name: Date: |

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