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Question for those of you on the P&T committees at your hospitals. How many of you have policies regarding the use of ketamine by nurses? And if so, can you send them to me?
Long story short, our hospital (a federal facility) received advice from a Nash inspection/consultation that because Florida RNs are not permitted to push ketamine for sedation, that there needs to be a policy to prevent them from doing so. And rather than just say "hey, if you're licensed in Florida, don't push ketamine" they decided to not allow any nurse in the hospital to push ketamine.
First off, I think this interpretation is incorrect, because now the director of nursing is stating that if I (as an ER doc) wants to intubate with ketamine, I can't have my RN push it, I have to push it myself, then run to the head of the bed, and do the intubation. While this can be hypothetically possible under ideal scenarios, I don't think it is best for patient safety. Further, they restrict its use for moderate sedation, and analgesia.
I have been able to find policy statements from multiple states with restrictions on RN administration of ketamine that make specific exceptions for intubation, but I can't find anything for Florida. However all the policy statements I have found from Florida seem to restrict ketamine for sedation purposes - and while RSI is technically a very deep sedation, I think they meant for moderate/procedural sedation.
Appreciate any help.
Long story short, our hospital (a federal facility) received advice from a Nash inspection/consultation that because Florida RNs are not permitted to push ketamine for sedation, that there needs to be a policy to prevent them from doing so. And rather than just say "hey, if you're licensed in Florida, don't push ketamine" they decided to not allow any nurse in the hospital to push ketamine.
First off, I think this interpretation is incorrect, because now the director of nursing is stating that if I (as an ER doc) wants to intubate with ketamine, I can't have my RN push it, I have to push it myself, then run to the head of the bed, and do the intubation. While this can be hypothetically possible under ideal scenarios, I don't think it is best for patient safety. Further, they restrict its use for moderate sedation, and analgesia.
I have been able to find policy statements from multiple states with restrictions on RN administration of ketamine that make specific exceptions for intubation, but I can't find anything for Florida. However all the policy statements I have found from Florida seem to restrict ketamine for sedation purposes - and while RSI is technically a very deep sedation, I think they meant for moderate/procedural sedation.
Appreciate any help.
