The registered nurse (RN) may administer Propofol, Etomidate and neuromuscular blocking agents (only Succinylcholine, Rocuronium and Vecuronium) to the non-intubated patient in a hospital setting for the purpose of rapid sequence intubation when the clinical presentation of impending respiratory failure is imminent.
Full Answer
Can a nurse administer succinylcholine?
The registered nurse (RN) may administer Propofol, Etomidate and neuromuscular blocking agents (only Succinylcholine, Rocuronium and Vecuronium) to the non-intubated patient in a hospital setting for the purpose of rapid sequence intubation when the clinical presentation of impending respiratory failure is imminent.
Can RNs push paralytics?
Dose titrations and boluses of anesthetic agents or neuromuscular blocking agents (paralytics) to be administered to the intubated and ventilated patient may be implemented by the registered professional nurse (RN) based upon specific orders or protocols signed by a qualified licensed physician.
Are nurses allowed to push propofol?
While it generally is accepted for RNs to administer propofol on a slow drip in intensive care units where most patients are intubated and mechanically ventilated, nurse-administered propofol is expanding to gastrointestinal endoscopy, ophthalmology, plastic surgery, and dental surgery.
Can RN push propofol in California?
California. It is within the scope of practice for the Registered Nurse (RN) to administer medications for the purpose of induction of conscious sedation for short-term therapeutic, diagnostic or surgical procedures.
Can a RN push propofol in Alabama?
What is the Alabama Board of Nursing's position on nurses administering various medications? However, RNs may be authorized to administer medications for Moderate Sedation in accordance with Standards established in Chapter 610-X-6-. 08 and always within scope of practice.
Can a RN perform a nerve block?
The RN may assist the anesthesia provider as a "third hand" for performing peripheral nerve blocks by aspirating and pushing the plunger of the syringe containing the anesthetic agents when directed to do so by and in the physical presence of the anesthesia provider.
How fast can you push etomidate?
When used alone for non-paralytic RSI, etomidate must be injected slowly, perhaps over 30 seconds to 45 seconds, to reduce the risk of etomidate-induced masseter muscle spasm.
Can an RN administer conscious sedation?
Certified Registered Nurse Anesthetists (CRNA's), anesthesiologists, other physicians, dentists, and oral surgeons are qualified providers of conscious sedation. Specifically trained Registered Nurses may assist in the administration of conscious sedation.
How fast do you push propofol?
Most patients require an infusion of 100 mcg/kg/min to 150 mcg/kg/min (6 mg/kg/h to 9 mg/kg/h) for 3 minutes to 5 minutes or a slow injection of 0.5 mg/kg over 3 minutes to 5 minutes followed immediately by a maintenance infusion.
Who can give propofol IV push?
There is one exception, however. Registered Nurses, who are competent in the procedure through education and experience, may administer Propofol to intubated, ventilated patients in a critical care setting based on an appropriate medical order.
Who can legally administer propofol?
“Whenever propofol is used for sedation/anesthesia, it should be administered only by persons trained in the administration of general anesthesia, who are not simultaneously involved in these surgical or diagnostic procedures.
Can nurses give propofol IV push in Florida?
Therefore the administration of propofol should only be performed by a practitioner experienced in general anesthesia and not by a registered nurse, with the exception of a patient who is continuously monitored and mechanically ventilated with a secured, artificial airway.
Do paralytics stop breathing?
The muscles of the diaphragm, which help expand the lungs, are also paralyzed by these medications. While under the effect of a neuromuscular blocking agent, you would need mechanical assistance to help you breathe because diaphragmatic muscle paralysis prevents you from breathing on your own.
Are paralytics used during surgery?
Paralytics (Muscle Relaxants) Paralytics are medications that induce complete relaxation of the muscles and help to facilitate intubation and surgery. These drugs are only at administered to patients that are completely unconscious and in a monitored setting.
How many mcgs of propofol can an RN give?
As an RN, I can give small boluses of propofol (usually not more than 10 - 20 mcgs), the patient is always intubated and already on the drip and the doc is usually in the room. I know that I rarely run a propofol drip or I never have an order for a drip more than 100mcg/kg/min - I think that gets into the anesthesia dose.
Can you titrate propofol in DC?
I don't know about PA, but in my hospital (in DC), we're allowed to titrate propofol gtts, but not allowed to bolus it. I had a pt. on propofol that was getting intubated, and the intensivist asked me to open the PLUM tubing so it was wide open, and he drew 5cc (50mg) with a syringe and then pushed it himself. I guess bolusing using the IV pump would have been too complicated :)
Is propofol a hypnotic sedative?
Technically, propofol is considered both anesthesia and a hypnotic sedative. So it begs the question of whether or not your institution acknowledges both labels.
Can a RN push propofol?
As far as I know RNs are only supposed to titrate propofol on a IV pump while a patient is mechanically ventilated. If a patient needs propofol for conscious sedation and does not have an artificial airway an RN should definately not be pushing propofol. But, I am not really sure if an RN can push a small bolus of propofol while the patient is on the ventilator.
Can nurses use propofol infusion?
In our facility, nurses may use propofol in infusion form and ONLY on vented patients in the ICU's. We do use it for some procedures in our interventional radiology area for our peds cases but then the intensivist has to be the one administering the med. Unfortunately, my state doesn't have standards of practice for conscious sedation, so our facility policies reign supreme.
Do we push etomidate or succs?
But then we do manage neuromuscular blocking agents. We never push etomidate, vec, succs, cis, or any of those for something like rapid induction for intubation, anesthesia does. But we do have ventilated patients paralyzed on vecuromium or succinylcholine gtts that we titrate to a train of four.
Is anesthesia a registered nurse's function?
The administration of anesthesia is a proper function of a registered nurse and is a function regulated by this section; this function may not be performed unless:
