Have you ever received sedation in the ER for a procedure like fracture reduction, chest tube, cardioversion, being intubated?
Have you ever taken your child to the ER for a dog bite to the face or a broken arm or leg?
THese proposed legislations would be like stepping back a decade in teh field of conscious sedation in the emergency room. The three drugs proposed are about the only 3 drugs I use anymore. Taking away the ability for ER nurses to administer them would relegate us back to using a combo of narcotics & benzo’s…an effective combination, but one that I feel is much, much harder to titrate.
There is ample research in the field of both adult and pediatric emergency medicine supporting the use of ketamine, etomidate and propofol over the older agents. THis would just be a disaster if it passed.
The State Board of Nursing has promulgated regulations regarding the administration of agents for sedation by licensed professional nurses. The proposed regulations would require all nurses who administer agents for minimal or moderate sedation to complete an annual sedation course, and would restrict the use of agents for deep sedation (i.e., propofol, etomidate, ketamine) to intubate, mechanically ventilated patients. General anesthesia or medications by which manufacturer insert indicate administration only by persons trained in anesthesia would be limited to the scope of practice of a Certified Registered Nurse Anesthetist (CRNA). If passed, the regulations have the potential to negatively impact the provision of state-of-the-art care to patients in the emergency department.
A State Board of Nursing hearing regarding these regulations has been scheduled in Harrisburg on February 12. The chapter will submit written testimony and has requested the opportunity to provide comment at the hearing.