when a order is written as such, it is asking the RN to titrate the dosage based on responses. but the order doesn't specify the parameters for titration. we don't do that any more after JCAHO said it was not appropriate.
--- "Nauman, Tanya" <[EMAIL PROTECTED]> wrote: > We have an order for "0.5ml to 2.0ml Ativan, p.o or > IV prn for PICC > placement, MR x1" as part of our routine orders. We > use it about > 30% of the time. > We try not to overuse it, but for patients who say > "I want to be > knocked > out" or exhibit signs of anxiety that continue after > our initial > attempts to > put them at ease, we do give it. We usually use > 0.5mg to 1 mg, but > have used up to 4mg.(and we don't "knock them out".) > > With anxious patients, we often see venospasm > making venous access > and advancement of the catheter difficult. We > realize that Ativan is > not a smooth > muscle relaxant, but when the patient is relaxed, > their veins don't > spasm. > I like to have the option available as it saves > time...rather than > waiting around for > 20-30 minutes to get a sedation order. > We take our peds patients to OR where they receive > general > anesthesia...this is > not what we would like, but we don't have a > conscious sedation team or a > child life > specialist...and after several fiascos in > pediatrics, we just take them > to OR. > Tanya R.N. > I.V. Support/PICC team/Educator > > > ________________________________ > > From: [EMAIL PROTECTED] > [mailto:[EMAIL PROTECTED] On Behalf Of > Kilbourne, Susan > Sent: Tuesday, June 26, 2007 3:50 PM > To: [EMAIL PROTECTED]; [EMAIL PROTECTED] > Subject: Ativan with PICC placements > > > I have recently been challenged by a physician on > our use of IV Ativan > with PICC placement. Our team often will ask for an > order prior to PICC > placement just in case the patient is anxious about > the procedure. I was > surprised when I did a recent audit to see that they > have been using > Ativan in 53% of our PICC placements. I am curious > what other teams are > doing. Is this standard of practice or have we gone > too far on this? > > Sue Kilbourne > Asante Infusion Services > > > > NOTE: The information contained in this message may > be privileged and > confidential and protected from disclosure. If the > reader of this > message is not the intended recipient, or an > employee or agent > responsible for delivering this message to the > intended recipient, you > are hereby notified that any dissemination, > distribution or copying of > this communication is strictly prohibited. If you > have received this > communication in error, please notify us immediately > by replying to the > message and deleting it from your computer. > > E-mail has the potential to have been altered or > corrupted due to > transmission or conversion. It may not be > appropriate to rely upon this > E-mail in the same manner as hardcopy materials > bearing the author's > original signature or seal. Thank you. Asante(r) > Health System > > > ___________________________________________________________ > This message is intended solely for the use of the > individual and entity to whom it is addressed, and > may contain information that is privileged, > confidential, and exempt from disclosure under > applicable state and federal laws. If you are not > the addressee, or are not authorized to receive for > the intended addressee, you are hereby notified that > you may not use, copy, distribute, or disclose to > anyone this message or the information contained > herein. If you have received this message in error, > immediately advise the sender by reply email and > destroy this message. > ____________________________________________________________________________________ Finding fabulous fares is fun. Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains. http://farechase.yahoo.com/promo-generic-14795097
