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February 2005, Volume 35 Number 2 , p 14 - 14




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    Please help. I work in a hospital outpatient department, where we perform endoscopies and colonoscopies on patients receiving procedural sedation. One of the physicians routinely oversedates his patients by ordering 50 to 100 mg of meperidine (Demerol) and 8 to 12 mg of midazolam (Versed), regardless of patient age, coexisting illnesses, or response to treatment. Recently this physician had to halt a procedure because the patient developed severe respiratory distress and needed treatment with reversal agents. Now he wants us to administer high-flow oxygen to all his patients .

    I don't think his patients would need such high concentrations of supplemental oxygen if they weren't so heavily sedated. When I spoke to my manager about this, she said that ordering medication is the physician's responsibility, not mine, so I shouldn't worry about it. What do you think? —P.D., MD.

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