Propofol

i may just be bls, but most of the time in my service area it is ALS assist--why do you need to worry about hypovolemia with this drug?


EDIT:

i apologize for my ignorance
 
EMT B said:
i may just be bls, but most of the time in my service area it is ALS assist--why do you need to worry about hypovolemia with this drug?


EDIT:

i apologize for my ignorance
Click to expand...

there are 2 doses, the sedation dose (low dose) and the anesthetic dose (high dose) the anesthetic dose can cause hypotension.

Usually mitigared by saline.

You can use the anesthetic dose as an IV anesthetic by itself without another agent.
 
EMT B said:
i may just be bls, but most of the time in my service area it is ALS assist--why do you need to worry about hypovolemia with this drug?


EDIT:

i apologize for my ignorance
Click to expand...

Propofol is generally a CCT level drug.

Hypovolemia is a concern because one of the actions of propofol is vasodilation and reduced inotropy. If you don't have the volume to make up for dialting vessels and a heart that isn't squeezing as hard you can get hypotensive quickly.
 
What Ven said. The Anesthesia guys are the ones that mostly use bolus propofol during induction. The few times I've had to push it in the ICU (ex: for intubation and nothing else was available) I did see some transient hypotension that resolved with fluid. Certainly something to keep an eye on and not usually a problem with maintenance doses for continued sedation.
 
We carry it but only for patients that we transfer out of our ER on vents. It works very well from what I have seen.
 
We carry it also for RSI. We administer 2mg per kg IV push followed by anectine 1mg per kg. We can follow up with 25 mg IVP and repeat that if necessary for continued sedation.
 
I just learned in my Forensics course at school in our drugs and tox unit that Michael Jackson died due to an OD on propofol. Was it the propofol itself, or the fact that there was also Ativan, Versed, Valium, lidocane and ephedrine in his body? Which brings up my next point...wouldn't epedrine have been counterproductive as a sleep aid?
 
EMT B said:
I just learned in my Forensics course at school in our drugs and tox unit that Michael Jackson died due to an OD on propofol. Was it the propofol itself, or the fact that there was also Ativan, Versed, Valium, lidocane and ephedrine in his body? Which brings up my next point...wouldn't epedrine have been counterproductive as a sleep aid?
Click to expand...

You JUST learned that's how he died?
 
BF2BC EMT said:
You JUST learned that's how he died?
Click to expand...

ok well i knew it was propofol but i didn't know what the hell that was until reading this. . .and then just made the connection I should say...so is my question going to get answered, cause that wasn't really the point...
 
While I am all for following protocol in order to stay out of prison, one day I'm going to hunt down the dude that came up with EMS protocols and the dude that coined the saying "it's protocol".....do something terrible. What, I have not yet decided.
 
Veneficus said:
You can use the anesthetic dose as an IV anesthetic by itself without another agent.
Click to expand...

Propofol is a sedative/hypnotic agent that was developed for and primarily used for induction of general anesthesia. Using it for ICU and procedural sedation was not really among it's initial indications. However, describing it as an anesthetic agent is not really correct. Propofol in and of itself has no analgesic properties. You can depress consciousness enough that a patient may not respond to a painful stimuli (all the way to a flat EEG) but that's not the same thing. I can assure you we do not and could not do surgery with propofol alone.
 
I just want to say, my dad was given it for a procedure, and it was hilarious when he woke up.
 
He was probably given another agent that produced this effect. Propofol doesn't produce the delirium that I think your referring to.
 
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