Georgia Board of Nursing Review – April 2015
Reviewed by Sedation Certification – March 20, 2019
State Sedation Policy – Yes
Can RN’s give sedation? – Yes
Can RN’s give Propofol/Ketamine? – Under Certain Circumstances – Intubated/Ventilated
Position Statement: Administration of Propofol, Etomidate and Neuromuscular Blocking Agents
Because sedation is a continuum, it is not always possible to predict how an individual patient will respond. Due to the potential for rapid, profound changes in patient conditions during sedation/anesthesia, agents such as Propofol require special attention.
Whenever Propofol is used for sedation/anesthesia, it should be administered only by persons trained in the administration of general anesthesia, who are not simultaneously involved in the surgical or diagnostic procedure. This restriction is concordant with specific language in the Propofol package insert, and failure to follow these recommendations could put patients at increased risk of significant injury or death.
It is not within the scope of practice of the registered nurse (RN) who is not a Certified Registered Nurse Anesthetist (CRNA) to administer agents used primarily as anesthetics for sedation, including Propofol (American Association of Nurse Anesthetists – American Society of Anesthesiologists Joint Statement Regarding Propofol Administration, 2004). This would include the non-intubated patient undergoing procedures, including but not limited to, invasive cardiology, invasive radiology, endoscopic gastrointestinal procedures, invasive bronchoscopy and emergent procedures.
Intubated and Mechanically Ventilated Patients in Critical Care Settings
It is within the scope of practice for the registered nurse (RN) to administer intravenous Propofol to the intubated, mechanically ventilated patient in continuous and bolus dosing, for ongoing sedation/analgesia within the Critical Care setting.
Emergency Airway Management in a Hospital Setting
The registered nurse (RN) may administer Propofol, Etomidate and neuromuscular blocking agents (only Succinylcholine, Rocuronium and Vecuronium) to the non-intubated patient in a hospital setting for the purpose of rapid sequence intubation when the clinical presentation of impending respiratory failure is imminent. This will be done in the presence of, and under the direction of, a physician credentialed in emergency airway management.
Prior to drug administration, registered nurses (RN) must demonstrate knowledge and skills which include evidence of education, training, and ongoing competency. Competencies include but may not be limited to ACLS/PALS and conscious sedation monitoring.
Georgia uses the scope of practice decision tree.