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3/1/23 md Propofol titration instructions update (Adults)
March 9, 2023

From: "Michele Durda" <michele.durda@hhsys.org>
To: "Critical Care Committee" <grp_critical_care_committee@hhsys.org>
Cc: "Pharmacists" <grp_allpharm@hhsys.org>
Sent: Wednesday, March 1, 2023 1:34:49 PM
Subject: Propofol titration instructions update (Adults)

Good afternoon,

The Titration and IV Medication Use Guidelines (ADULT) were recently updated on PULSE. Please discard any old print-outs that you may have

https://docushare.hhsys.org/dsweb/Get/Document-53195/Titration%20and%20IV%20Medication%20Use%20Guidelines%202023.pdf

The update includes a change to the standard titration instructions for propofol:

NEW:

Titrate by 5 to 10 mcg/kg/min at 5 minute intervals to achieve a RASS score of ‐1 to 0; if neurologically impaired (unable to follow commands), keep RASS ‐3 to 0.

PREVIOUS:

Titrate UP by 10 mcg/kg/min or DOWN by 5 mcg/kg/min at 5 minute intervals to achieve a RASS score of -1 to 0; if neurologically impaired (unable to follow commands), keep RASS -3 to 0.

The default titration instructions for propofol in Cerner will be updated this afternoon. Please note that the provider can always change the defaults so it is important to always read the titration instructions on your orders