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NJANA_Ketamine_Infusion_Ther.pdfSafe Injection Practices
Operating Room Fires
Operating room fires are a rare but preventable danger in modern healthcare operating rooms. Optimal outcomes depend on all operating room personnel being familiar with their roles in fire prevention and fire management. Despite the recommendations of major safety institutes, this familiarity is not the current practice in many healthcare facilities. Members of the anesthesiology and the surgery departments are commonly not actively involved in fire safety programs, fire drills, and fire simulations that could lead to potential delays in prevention and management of intraoperative fires (Hart, Yajnick, Ashford, Springer, & Harvey. Ochsner J. 2011 Spring; 11(1): 37–42).
The current FDA warning on propofol states:
For general anesthesia or monitored anesthesia care (DIPRIVAN) Injectable Emulsion should be administered only by persons trained in the administration of general anesthesia and-not involved in the conduct of the surgical/diagnostic procedure. Patients should be continuously monitored, and facilities for maintenance of a patent airway, artificial ventilation, and oxygen enrichment and circulatory resuscitation must be immediately available.
For sedation of intubated, mechanically ventilated adult patients in the Intensive Care Unit (ICU), DIPRIVAN Injectable Emulsion should be administers only by persons skilled in the management of critically ilt patients and trained in cardiovascular resuscitation and airway management.
in the elderly, debilitated or ASA WIV patients, rapid single (or repeated) bolus administration should not be used during general anesthesia or MAC sedation in order to minimize undesirable cardiorespiratory depression including hypotension, apnea, airway obstruction, and/or oxygen desaturation.
1. Considerations for Policy Development Number 4.2, titled “Registered Nurses Engaged in the Administration of Sedation and Analgesia” (AANA document, located at click here).2. Qualified Providers of Sedation and Analgesia (AANA position statement number 2.2, located at click here). 3. AANA-ASA Joint Statement Regarding Propofol Administration (located at click here). The statement is dated April 14, 2004 and remains in effect.
Scope of Practice:
The Scope of Practice developed by the AANA addresses the responsibilities associated with anesthesia practice that are performed in collaboration with other qualified healthcare providers.Click here to view a pdf.
Professional Practice Resources:
These resources provide foundation for practice management and considerations. Click on the item to learn more.
Standards for Nurse Anesthesia Practice:The AANA Standards for Nurse Anesthesia Practice offer guidance for Certified Registered Nurse Anesthetists (CRNAs) and healthcare institutions regarding nurse anesthesia practice. CRNAs are responsible for the quality of services they render. Click here to view a pdf.