Arkansas BON Review – May 11, 2017
Reviewed by Sedation Certification – Jan. 4, 2019
State Sedation Policy- Yes
Can RN’s give sedation- Yes
Can RN’s give Propofol/Ketamine- Under Certain Circumstances- Intubated/Ventilated
Arkansas State Board of Nursing
UNIVERSITY TOWER BUILDING, SUITE 800
1123 SOUTH UNIVERSITY AVENUE
LITTLE ROCK, ARKANSAS 72204-1619
Telephone 501.686.2701 * Facsimile 501.686.2714
Role of the Registered Nurse in the Management of Patients Receiving Moderate Sedation, Anesthetic Agents or Neuromuscular Blocking (paralytic) Agents For Therapeutic or Diagnostic Procedures
The Arkansas State Board of Nursing has determined that it is within the scope of practice of a registered nurse (RN) who has demonstrated competency to administer pharmacologic agents under direct supervision of a physician or advanced practice registered nurse (APRN) to produce moderate sedation and to assist in rapid sequence intubation (RSI). Air and surface transport RNs in the field may administer pharmacologic agents under the direction of the physician or APRN. Consistent with state law, the attending physician, APRN, or a qualified provider must order the drugs, dosages, and concentrations of medications to be administered to the patient. Optimal anesthesia care is best provided by anesthesiologists and certified registered nurse anesthetists (CRNAs). The Board recognizes that the demand in the practice setting necessitates non‐APRN RNs to administer anesthetic agents or neuromuscular blocking (paralytic) agents in specific circumstances. The RN shall have the educational preparation and clinical competence to administer anesthetic agents or neuromuscular blocking (paralytic) agents to assist in moderate sedation, RSI, therapeutic, or diagnostic procedures. These specific circumstances include:
1. The RN administering a continuous infusion of an anesthetic agent or neuromuscular
blocking (paralytic) agent to a hospitalized patient who is intubated and ventilated in an
acute care setting for the purposes of maintaining comfort, stable oxygenation and
ventilation, and a viable airway. A physician qualified in the administration of anesthetics
or an APRN shall determine the continuous infusion dosage. Dose titrations and boluses
of subsequent anesthetic agents or neuromuscular blocking (paralytic) agents to be
administered to the intubated and ventilated patient may be administered by the RN
upon specific orders or protocols by a physician or APRN.
2. The RN administering sedation for comfort care in the final hours of life under the
direction of a physician or APRN.
3. The RN administering sedation for procedure where the physician or APRN is present
but unable to personally inject the agents because the physician or APRN is performing
the critical procedure of emergent intubation.
4. The air and surface transport RN administering sedation for a procedure in the field
setting under the direction of a physician or APRN.
5. The RN administering anesthetic agents in placement of peripheral nerve blocks that
may require the use of both hands of the physician or APRN to not compromise patient
6. The RN administering anesthetic agents for therapeutic care including pain management
or treatment of agitated delirium.
As with all areas of nursing practice, the RN shall apply the Nurse Practice Act and Rules to the specific practice setting, and shall utilize good professional judgment in determining whether to engage in a given patient‐care related activity. Employing facilities shall have policies and procedures to guide the RN. The Arkansas State Board of Nursing has adopted the attached guidelines.
Adopted November, 1994
Revised September 17, 2009
Revised September 12, 2014
Revised May 11, 2017
Please click link above to view references.