Propofol (Diprivan) - Critical Care Medications
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- čas přidán 14. 06. 2024
- We continue with the critical care medications series by next talking about everyone's favorite, Propofol, AKA Diprivan. This is a sedative/hypnotic that is very powerful and very useful, when used properly. In this lesson, we take at look at it, including our uses.
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0:00 Intro
00:57 What is Propofol?
3:00 Side Effects
4:18 Administration
5:01 Monitoring
7:10 Uses in Critical Care
10:35 Wrap up
#ICUAdvantage #Propofol #Medications
I’m so glad that you pointed out that while the patient is sedated they are not pain free. I see this overlooked constantly in hospitals. ‘Just because our patients can’t complain of pain doesn’t mean they are pain free’
100%
I've seen it far to often and a really important thing to understand!
@@ICUAdvantage
Isn't it relatively common practice to push fentanyl or hydromorphone or morphine together with the Propofol?
But you can easily perform TIVA using only propofol for electrical cardioversion
100% accurate. I've had 4 cardioversions since March 2020, and out of those 4, propofol was used twice (the other 2 were done using ketamine).
@@Mommyandtux -- For intubated patients, fentanyl is really great, because it seems to disproportionately blunt response to pharyngeal and laryngeal stimulation. Even a little bit of fent can make a big difference as to how well the patient tolerates a tube, and how much sedative they need.
Whenever I am sedated to have a surgery I have Propofol. I love it, the feeling I get from it just before I fall asleep.
Thanks for this video. 🙏
So much better than a textbook. Thank you!
Great to hear this Megan. Glad you liked it.
Thank you. Brief yet with enough details.
thank you! ive been doing a marathon of lessons from your channel, it helps a lot!
Awesome! That could be a LONG marathon! lol
So helpful for newly joined icu nurses...all of ur videos are so helpfull for me....ty❤️
All your videos and so helpful and give me helpful information!
These are absolutely amazing
I'm definitely going to be watching these and writing stuff down. Keep up the incredible work
Awesome! Glad you liked it!
Best Videos on CZcams all the time. Thank you so much
Awesome!!!
ER RN we use this a lot and wow :) thank you for the lesson
Thank you thank you thank you. I love your channel, you're such a great educator
I appreciate the kind words!
I love it!!!💕 I get it for spine injections at Pain Management.
Thank you so much Eddie, love your channel !
Happy to help Winnie! 😊
great lesson! thank you for sharing the information.
Absolutely my pleasure! 😊
I am pediatricintensivist from India.appreciate your presentations
A very great video,, thanks so much,, plz continue these useful videos,, I am always waiting 4 them
Thank you so much! I will definitely keep making them!
Make a video on stages of anesthesia specially depth of anesthesia
Thank you so much so much. Critical Care Paramedic here!
You're so welcome! Definitely a lot of good info here for you guys!
Thanks for the videos. Amazing explanation!!!
My pleasure! Glad you enjoy them. Thank you!
Awesome video! I'm orienting in the ICU and honestly I need to keep educating myself about the nursing considerations for each drip. This helped a lot. Is it possible to do a video on Precedex? My ICU uses that one a lot for the sake of SBTs.
Glad you find them helpful. And yeah I do have Precedex on the todo list!
excelent information thanks. i am new at anestesiology very usefull video thanks Doctor. my best from México
Thank you for this content!
You are very welcome!
In my opinion propofol is one of the God sent developments in the history of medicine. At least regarding patient comfort. Due to past nightmare procedures I will never submit to any potentially painful procedures or treatments without it.
Greetings from Brazil! Nice work!
Awesome! Hello in Brazi! Thank you!
amazing video thank you
Great info! Thank you
Glad to hear this! You are very welcome Shawn!
Thanks for this video!
You're very welcome!
When in doubt knock em' out. I have been redeployed to the ICU and your videos are helping me so much!
Don't forget there are consequences to sedation too. As much as we love propofol, we have to make sure we use it appropriately 😉 Glad you are liking the videos!
@@ICUAdvantage what about the risks of patient extubating themselves?
@@eduardodiaz9354 That is certainly a risk to weigh in the decision for sedation. Restraints are also another option to help mitigate this, while keeping sedation levels lower.
I'm certainly no advocate for no sedation, but it also needs to be used appropriately and at the right level.
@@ICUAdvantage unfortunately at my hospital they don’t use restraints 😞. I’ve been listening to a podcast you should look it up “Walking home from the ICU” there is a facebook page too go look at some of their videos
very good work
Wow 1,000+ likes to 6 dislikes.
That's one of the highest like:dislike ratios on CZcams.
I gave you another like and a sub, keep up the good work.
Awesome man! Much appreciated! I will certainly do my best to keep them coming.
thanks for the video :)
I’ve not seen this med used for status epilepticus. Thank you for pointing that out!
I have tle, and i never heard it being used for epilepticus either. It's always been midazolam bc it is way stronger. Dosed 20x lower than this drug
Thanks!
Can you do a video on insulin drips? Thanks for the videos! They help a lot!
I do have it on the todo list! 😊
@@ICUAdvantage please! Insulin is terrifying because it can be so dangerous! Thank you 💚
Loved the video. I'm am ER nurse. My ER rarely uses Propofol except for procedural sedation as a one time dose. Nobody really talks about how to use propofol because we usually use fentanyl and versed. Thanks for the tips!
Its interesting how different providers do things differently. I much prefer Prop for a lot of reasons, but unfortunately not always possible to use.
our er uses it for intubation after etomidate and rocuronium for post intubation sedation but not for procedural sedation mostly etomidate and ketamine
Wonderful work
Go on
Thanks
Thank you so much!
Great video Eddie
Appreciate you Justin! Happy to hear you liked it!
yes great video ! regards liz from uk 🇬🇧
Awesome! Thank you Liz! 😊
If you haven’t done one yet, could you do one on ketamine!?! Your videos help a ton as a new ICU nurse!
Thank you! happy to hear they are helpful for you. I have not done Ketamine yet, but it is on the todo list!
Great informative lecture
Glad it was helpful!
Thank you..🙂👍🏾
You're welcome! 😊
Hi I think it's action is through Hyperpolarisation of Chloride channels (GABA acts via Chloride receptors). Not Calcium channels, but great summary of the drug though.😅
Ahhh yes I went back and looked and you are 100% correct. Chloride influx creates the negative potential and stops the AP! Thanks for the catch!
Thanks
You are welcome as always! 😊
Great informative video! It is also excreted through exhalation
Thanks bro 👍👍👍👍
Absolutely my pleasure!
great content!
Glad you like it Matt!
Good and useful
Glad you think so!
Good content
Thank you🙂
You're welcome 😊
@@ICUAdvantage Your lesson are so informative. Thanks for updating 🙂
Very helpful
Glad to hear it!
Hi ICU Advantage,
May you consider doing a video on buprenorphine
Thanks for this awesome 👌 video
I have quick question
Sometimes they used combination of propofol + ketamine. What do think about that ?!
Thanks for the video. One bit I'm not quite clear on, you said that GABAA potentiates calcium influx. Did you mean to say chloride influx? Potentiating chloride influx has the inhibitory effect (being negatively charged), whereas calcium should have the opposite effect. Inhibition of calcium influx in neurons is a MOA for opioids to reduce pain transmission in the spinal cord. At least that's how I've understood it, unless your reference says something different? Thanks in advance.
thank you so much! loved this lesson. do you think.you can cover also dexmedethomidine?
Yes! It's on the todo list!
That's there a nyc piece of info.. 🥰
Yay!!! 😊
Nice......
Thank you!
Great video as always!
What dosage would you recommend for gastroscopy and colonoscopy?
Thank you Rade. The procedural sedation dosing mentioned.
Hi there, how about the usage of propofol in ventricular tachycardia?
great
You’re awesome
Tell me does this hit the gaba a receptors. If I've just come off benzodiazepines what are the alternatives for general anesthetic. I'm somewhat concerned..can fentanyl only be used for general anesthetic. As can't have anything that acts on gaba a receptors. As downregulated by benzodiazepines.
Propofol-related infusion syndrome ( PRIS) always reminds me of Michael Jackson
You forgot one indication of this medication, General anaesthesia for prolonged invasive oral procedures in the dental office setting. Can be afministered chairside prior to nasal intubation for dental work
Any USA propofol clinical trials for treatment resistant depression w psychotic features yet? I have abnormal epileptiform eegs for decades now without actual seizures. Propofol after effects for a colonoscopy i had was an absolute mood miracle for me, however short lived.
Hi Eddie. I am watching your videos to prep for CRNA school interviews. I noticed on this propofol video that you state that it helps to slow closing of calcium channels on GABA receptors. I have read on multiple sources that propofol works by prolonging the opening of chloride channels to hyperpolarize the cell. Could you clarify this for me please?
Nice
Thanks
Important question for the author, please help me put my mind at ease as I suffer from severe health and cardiovascular related anxiety. I am scheduled for a procedure in about 20 days, and I am worried. When I wake up in the mornings, it's extremely common for my heart rate to be in the high 40s, so technically already in Bradycardia, and my BP has been 98/69. When I get out of bed and moving these things go up to what one would consider average. Heart rate hangs around upper 60s, and BP is 120/75 approximately. As my heart rate is often this low during sleep or rest, am I at increased risk of an even lower heart rate and does propofol pose more risk to someone like me who has a low heart rate at rest? Also if relevant I have a completely normal heart,, two EKG's in the last 6 months showed not even so much as a sinus arrythmia. I got a good bill of health as far as heart health. So anyway, am I in danger of higher chance of mortality or danger of any sort?
Would you be able to explain why a patient in ICU with multiple grand mal seizures would be on both propofol and Versed at the same time? Why can't the patient be on just propofol without Versed? Thank you.
Can you do a talk on propofol and TCI
Another great video 👍🏽👍🏽. Thanks for putting in the work.
Thank you so much! Truly my pleasure!
Does propofol decrease the body temperature?
Are there any contraindications using propofol with patients with high potassium like crush injuries? I recently learned that GABA be receptors act on moving potassium to create hyperpolarity.
What qaunitiy propofol add for solusions ? what type solution correct use mixed with propofol?what dose can used for 24 h safely?
While changing the tubing, do you need to also change the cannula too
Nope!
What are some Red flags with use? Signs that you need to titrate the drug?
How do I obtain this for personal use
When doing hourly neuro checks on a patient on prop....would one just turn off every hour or would one wean prior?
Great question and it kind of depends on the rate they are at. If its pretty low, 5-15, you might be able to just pause it, let them wake up, get the assessment and put it back on at the rate you were at.
For higher rates, sometimes you don't even need to fully turn it off. If you can get the assessment you need without going completely off, thats great. Sometimes, especially with more significant deficits and injury, you need to be sure you are scoring as low as you are getting and that would require fully turning it off. At higher doses, you may need to quickly wean it down to off. Usually not a good idea to just turn it off as they can wake suddenly and it can cause more agitation and issues.
love the milk of anaesthesia
It is a great drug!
Is watching this channel good prep for CCRN?
I’d like to think so. I’ve got a lot of good videos that I think would be helpful
Hai Edie I’m deshani again from srilanka and I’m cardio thoracic icu nurse 👩⚕️ and this vedio updated my knowledge again and again .thank you .aren’t you interested about PiCCO technology ? Can u give us a vedio about PiCCO? Then 👋
I personally haven't seen/used it, but I've had a few requests on it, so I'll have to consider covering it in the future.
Gotta wonder how much is actually "remembered." I suppose the right jumping off point is asking anesthesiologist what they have seen in sedated people?
facing difficulty to calculate infusion . ml per hour
❤👍
Hi sir..am a CCT student...
Awesome!
can i use propofol instead of melatonine pill for sleeping i want to sleep immidiately
no
Can propofol be used repeatedly for short procedures
Yup. An effective push dose can be given, and if the procedure is not over and they are beginning to waken, more can be given.
Tq😁
I am sorry, but i thought that dosage for continuous infusion is measured in mcg/kg/HOUR, not MINUTE
There are dosing ranges that I've seen in mg/kg/hr, but for the doses that I was referring to they are mcg/kg/min
Overdose of this shit killed mj .
PLEASE MAKE A VIDEO ON NON INVASIVE VENTILATION
I do have it already. Look for the blue background in the videos and CPAP vs BiPAP
mmmm feels so good...MJ 4 eva
MJ favorite drug
was*
Ahhh yes the milk of amnesia. Good ole propofol.
Trust me - I watched a CZcams video! 😆I kid. I kid.
Imagine going through med school so u can steal some propofol for a crazy suicide
I got my cavity extracted by pulling the tooth out today and the root and the used propofol on me and I was scared and cried and even tho I was scared and saying don’t put it in yet and than they injected the propofol in me anyway and all I Remembered was my vision starting clear and slowly get blurring and after my vision got fully blurry i than Remember nothing after that
It than I woke up and I felt pain on my left cheek and To be honest I didn’t feel anything or remember anything after the procedure
It was like I closed my eyes for 5 secs and than woke up
It’s not scary at all My mom put on video me freaking out and cry before then put in the propofol so when I watched the video she took when the sedative was injected by the doctors I think now when looking at the video I look like a complete wussy lol 😂
Shoutout Michael Jackson
Su lechita y a dormir
Thanks!
Thank you so much for this Maureen!