Administering Propoflo/Vetofol/Rapinovet etc

Re: Administering Propoflo/Vetofol/Rapinovet etc

Stuart Ford-Fennah — Sun, 02 Dec 2012 13:07:23 GMT

If it helps.. we're a referral centre and have a blanket rule nurses dont induce ananethesia because of the RCVS guideline - we still have discussions about it though because it seems such a grey area and some people do try to push these boundries - despite the clear advice given by the RCVS and the policy of the hospital.

Re: Administering Propoflo/Vetofol/Rapinovet etc

Sal the 1st — Sun, 02 Dec 2012 11:09:17 GMT

[quote user="Laura Ringsell"]

I agree entirely with Steph, if the dose is 10 ml and 8 mls is clearly enough what do you do? If you give the 'correct dose' do you give it steadily or slowly....to effect? There are restrictions on what we are allowed to do for a reason, however much we feel they are petty we must follow these guidelines. If necessary contact the rcvs for clarification if the regulations seem a little wooly. I am amazed that this keeps coming up

[/quote]

it keeps coming up repeatedly (along with a lot of other stuff, ie vaccinations ) just because there are people out there who feel that they need to keep pushing at boundaries that have often been put there for very good reasons and dare I say pushing their luck into the bargain.

I can empathise with Nicola - I feel she is in a difficult position. I am well aware that there are nurses out there that would and have done this but it doesnt make it right

Re: Administering Propoflo/Vetofol/Rapinovet etc

Laura Ringsell — Sun, 02 Dec 2012 07:23:26 GMT

[quote user="Steph Worsley"]

[quote user="PHA86"]

We administer Propofol at work, however do not give incrementally, just the correct dose for the weight of the patient.

[/quote]

The problem with this is there is actually a large dose range 1-4mg/kg for premedicated animals so the dose that is correct for one 10kg animal (for example) is not the correct dose for the next 10kg animal.....it is a drug that is given "to effect" to induce anaesthesia so technically should not be administered by VN's.

If it was a nice easy thing and 1 dose rate fitted all then yes we could but it's not.

[/quote] I agree entirely with Steph, if the dose is 10 ml and 8 mls is clearly enough what do you do? If you give the 'correct dose' do you give it steadily or slowly....to effect? There are restrictions on what we are allowed to do for a reason, however much we feel they are petty we must follow these guidelines. If necessary contact the rcvs for clarification if the regulations seem a little wooly. I am amazed that this keeps coming up

Re: Administering Propoflo/Vetofol/Rapinovet etc

Steph Worsley — Sat, 01 Dec 2012 14:26:54 GMT

[quote user="PHA86"]

We administer Propofol at work, however do not give incrementally, just the correct dose for the weight of the patient.

[/quote]

If it was a nice easy thing and 1 dose rate fitted all then yes we could but it's not.

Re: Administering Propoflo/Vetofol/Rapinovet etc

PHA86 — Sat, 01 Dec 2012 12:05:06 GMT

We administer Propofol at work, however do not give incrementally, just the correct dose for the weight of the patient.

Re: Administering Propoflo/Vetofol/Rapinovet etc

Laura Ringsell — Fri, 30 Nov 2012 18:31:50 GMT

Nicola, I would print out the rcvs guidelines specific to anaesthesia and ask to have a discussion about it. Don't forget if you are an rvn then you are accountable for your actions, and if you do something you know is wrong then need to take responsibility for the outcome- that's enough of a reason for me and should be enough for them too. Good luck and I hope you get a positive outcome. Nurses should not be inducing anaesthesia to effect, you are right. http://www.rcvs.org.uk/advice-and-guidance/code-of-professional-conduct-for-veterinary-nurses/supporting-guidance/delegation-to-veterinary-nurses/

Re: Administering Propoflo/Vetofol/Rapinovet etc

Nicola Wordsworth — Fri, 30 Nov 2012 17:48:40 GMT

Thankyou for getting back to me :)

However, where do I now stand if asked to do it again? Can I politely say I decline because I am not allowed to dose 'to effect'. I have a feeling its going to be uncomfortable for me for the next few days at work as one vet and nurse in particular seem keen for me to do it (off the needle with no catheter!) and obviously I dont want to.....

Re: Administering Propoflo/Vetofol/Rapinovet etc

Rachel B — Fri, 30 Nov 2012 09:04:56 GMT

As far as i was aware, (and i cant for the life of me think who it was that told me, lecturer at uni perhaps) we CAN give it, but as its given to effect there no point as we have to have been directed exactly how much to give and quite frankly, as you'd have to have a vet standing over your shoulder telling you exactly when to stop, so they might aswell do it themselves in that case. As i'm writing this i see other people have said pretty much the same thing!

Never seen the need to do it myself personally but maybe i've just been lucky and not had a lazy vet/one that tries to do everything at once

Re: Administering Propoflo/Vetofol/Rapinovet etc

Paulette — Thu, 29 Nov 2012 18:48:01 GMT

there was a somewhat heated discussion about this a few months ago. if you do read, please read thoroughly so you don't get confused in the hype!

http://www.vetnurse.co.uk/forums/t/16473.aspx?PageIndex=1

basically:

- as Gill said only vets can administer anaesthetic drugs incrementally (to effect)

- only vets may administer anaesthetic drugs as a top up of anaesthesia

- listed qualified, registered, and student (enrolled with the RCVS) veterinary nurses may give prescribed quantities of anaesthetic drugs under the direction of a vet, acting on behalf of their employer eg triple anaesthesia, sedations and propofol/alfaxalone boluses to induce anaesthesia

if you would like to you can pm me your email address and I can forward the correspondence I had with the RCVS regarding this enquiry

hope this helps :)

Re: Administering Propoflo/Vetofol/Rapinovet etc

Gillian Emmett — Thu, 29 Nov 2012 18:11:20 GMT

Hello! I had a similar discussion the other day and when we looked into it only vets can admister anaesthetic drugs that are administered to effect such as propofol. VNs can administer any anaesthetic that it given at a specific dose such as a triple combination.

hope that helps!

Re: Administering Propoflo/Vetofol/Rapinovet etc

Steph Worsley — Thu, 29 Nov 2012 18:09:38 GMT

This is taken from the RCVS website regarding schedule 3: As I understand it if I we are told the amount to give then we can give that however if it is incremental dosing then we cant:

Maintenance and monitoring of anaesthesia

18.8 Veterinary nurses and student veterinary nurses may be directed to assist veterinary surgeons with the maintenance of anaesthesia and the monitoring of patients under anaesthesia. The following advice applies to these tasks:

Inducing anaesthesia by administration of a specific quantity of medicine directed by a veterinary surgeon may be carried out by a veterinary nurse or, with supervision, a student veterinary nurse, but not any other person.
Administering medicine incrementally or to effect, to induce and maintain anaesthesia may be carried out only by a veterinary surgeon.
Maintaining anaesthesia is the responsibility of a veterinary surgeon, but a suitably trained person may assist by acting as the veterinary surgeon’s hands (to provide assistance which does not involve practising veterinary surgery), for example, by moving dials.
Monitoring a patient during anaesthesia and the recovery period is the responsibility of the veterinary surgeon, but may be carried out on his or her behalf by a suitably trained person.
The most suitable person to assist a veterinary surgeon to monitor and maintain anaesthesia is a veterinary nurse or, under supervision, a student veterinary nurse.