I believe there were issues with generic propofol a couple months ago. So they had to pull those batches out of circulation and we ended up with the current situation. I know for awhile we were getting Propoven, which is the European version.Not to get completely OT, but this begs the question (that I've had with lots of other drug shortages). What was AstraZeneca thinking? How did we get to a shortage of propofol in the first place? Michael Jackson is dead so it must be at least semi-legit uses responsible for the consumption of it. I assume all of this is tracked. Did they not at least send somebody to the warehouse to look and see how much was left?
Ummm...fentanyl and versed.
Given that I treat acute pain with 0.1mg/kg to start, that morphine dose seems a little low to me for vent sedation on the average adult.so when i review the drip ranges they are pretty wide. in an emergent situation i like to keep things simple. is the below reasonable for your average human s/p intubation who begins to thrash around:
if using versed, 5mg versed IVP then 5mg/hr drip?
if using fentanyl, 100mcg IVP, then 50mcg/hr drip?
if using ativan, 3mg IVP, then 3mg/hr drip?
if using propfol, 30mg IVP, then 20mcg/kg/min titrate up to 50mcg/kg/min?
if using morphine, 4mg IVP, then 4mg/hr drip?
anyone care to make changes, give their input.
in my case, i intubated an OD then ordered propofol, to my surprise there was none in the ED. i realized that as a resident i should've switched it around to get experience with other methods of sedation. not fun when i have to dance around and read through my pharmacopia as the nurses look at me desparetly waiting for an order!