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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