In message <[log in to unmask]>, Craig Ellis
<[log in to unmask]> writes
>I thought the list would find some recent recommendations from a Australian
>and New Zealand College of anaesthetists publication interesting ( or should
>that read amusing ?). Apparently only anaesthetists are qualified to sedate
> - children < 12
> - adults > 70
> - anyone > 90 kg
> - with any new agents such as ketamine or propofol
> - patients with any chronic illness
> - patients with any medication allergies
The line insertion service (specialist nurses) in our trust (who are
brilliant at their job) have a protocol to enable them to use midazolam
(as long as we have prescribed it) and by definition most of the
patients have a chronic illness, there often isn't a doctor in sight
when it is used. The important point is that they use a tiny dose only
and seem to have no problems at all (they always make sure there is some
flumazenil around before starting and have another nurse from the ward
present and monitor sats, and insist on an empty stomach). We ahve to
be careful with policies like the above that are very sweeping, and
undoubtedly safe but also prevent a lot of sensible use of these agents
by sensible people.
--
Sam Waddy
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