Hi Tony,
Did I understand your email re: propofol? Are you using it in non-intubated
patients? At one time, this option was explored in our unit for various
things, even those being weaned from vents and battling delirium tremors.
We love diprivan, however, pharmacy and the nursing staff pointed out that
the use of diprivan on non-intubated patients is not endorsed or recommended
by the FDA, drug manufacturer or nursing org such as AACN. Any experience
with this at your place?
Vicki Bennett, RN, MSN
Trauma Program Manager
Memorial Regional Hospital
Hollywood, FL
-----Original Message-----
From: Mitchell, Tony
To: 'traumanurses@mailman.listserve.com'
Sent: 6/13/2003 4:34 PM
Subject: [traumanurses] Re: Need some help with agitated neurotrauma patie
nts
Phyllis,
After trying every possible way we knew, we have found that if a family
member cannot stay with the patient, minimal doses of Propofol,
Midazolam, and soft restraints work the best on our agitated head injury
patients. We only use enough Propofol to prevent them from injuring
themselves and that dose is clearly patient specific. Usually the family
member has minimal involvement unless you can see an obvious positive
response from the patient but the family member can see how difficult it
is to manage their loved one and this is very important in other ways.
The neurologists usually call or have certain times they make rounds and
ask that we shut the Propofol off about ½ an hour before they arrive so
they can assess the patients status. Frequent attempts are made to
decrease the Propofol and balance with increased Midazolam until
eventually you can get everything off. Hope this helps.
Tony Mitchell RN, CCRN,
Trauma Coordinator
St. John's Regional Medical Center
Joplin, Missouri, 64804
Office- 417-627-8337
Pager- 888-665-1827
email- tmitchel@stj.com
-----Original Message-----
From: Uribe Phyllis [mailto:Phyllis.Uribe@HealthONEcares.com]
Sent: Friday, June 13, 2003 3:09 PM
To: 'traumanurses@mailman.listserve.com'
Subject: [traumanurses] Need some help with agitated neurotrauma
patients
Greetings, all. As you head off into your weekend, our neurotrauma unit
is looking for some creative ideas on how to assure safety for agitated
brain injured patients. They often request an order for a "sitter" or
"behavioral attendant" to stay with the patient, but staffing and budget
constraints mean that is not always available. Any ideas you have used
or policies for deciding between drugs, restraints, and attendants would
be welcomed. Thank you in advance.
Phyllis Uribe RN BSN CCRN
Trauma Program Supervisor
303-788-5082 (office)
303-788-6928 (FAX)
Phyllis.Uribe@HealthONEcares.com
www.swedishhospital.com
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