I am interested that you use Propofol for sedation in the A&E dept. Dr. Ellis.
My experience is of considerable resistance (mostly from Anaesthetic colleagues)
against its use by "non-anaesthetists". Some A&E colleagues have said that "it
is an anaesthetic drug so we cant use it".
I have felt that it is a suitable drug when used for sedation for manipulations,
by an experienced operator - an emergency physician with advanced airway, and
resuscitaion skills, with appropriate monitoring and resus facilities. Also,
do we not use other dangerous "anaesthetic" drugs with apparent lack of criticism
- opiates, benzodiazepines, general anaesthetics for RSI?
I proposed a randomised blinded trial of propofol against opiate/midazolam for
manipulations in A&E, to look at times to recovery and safe discharge home,
as well as safety.....and it was thrown back in my face by the Anaesthetic dept.
I would be interested to know list members views and current practice.
Sorry for the long email - but this is an area I am interested in!
Marten C. Howes
SpR
Blackpool
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