I like ‘em sedated October 27, 2007
Posted by keepbreathing in Medical Blogs, links.trackback
It’s true. I like my patients to be well-sedated. There are some out there who think it’s cruel or unpleasant to sedate patients in the ICU environment, but speaking as someone who knows intimately the depths of the unpleasantness we can inflict on people in the drive to cure them, I think that sedation is a gift from above. Patients in the ICU are going through some of the most trying times of their lives: why wouldn’t we sedate them for it?
My favorite sedative agent would have to be the wonderful, beautiful and heavily-used drug Propofol. Terry at Counting Sheep has a wonderful post about this drug, which I urge you to go read immediately.
I, too, like to keep my intubated patients sedated. One of the last patients I took care of last month was a known drug sopper-upper and was very well known to the PICU staff. He was admitted to us after a tracheoplasty and anterior rib graft and was nasotracheally intubated. The goal was to keep him “stoned to the bejeezus”. The first thing I did when he rolled in was to write for morphine, vecuronium, and ativan. That kept him nice and quiet all night.
We don’t use much propofol in the PICU (aka “Milk of Amnesia”). It’s use in PICUs is poo-poo’d, according to one of my attendings. Although, when we get the odd 16 or 17-year-old s/p MVC or other trauma that comes to us tubed, we tend to use it over our typical method of PRN sedation.
Sedation is KEY when it comes to these patients. I love them comfortable. I don’t want them to remember the horrors. Propofol is the best thing ever.
Don’t ever leave me intubated WITHOUT a Propofol drip, thank you very much!