By Simon Hendel.
Nurses at The Canberra Hospital have been administering powerful anaesthetic drugs during endoscopies for more than a decade without the supervision of suitably qualified doctors, in contravention of the College of Anaesthetists’ guidelines.
7.30 has confirmed nurses administered drugs in The Canberra Hospital’s gastroenterology suites, from 2000 to 2016, outside Australian anaesthesia guidelines.
The drugs included the potent anaesthetic drug propofol, as well as the strong sedatives fentanyl and midazolam.
Under the guidelines, the use of propofol for general anaesthetic or sedation should be reserved for anaesthetists or doctors with specialised training, who are solely responsible for the sedation.
Guidelines state that “deeper sedation or general anaesthesia must not be used unless an anaesthetist, or other trained and credentialed medical practitioner within his/her scope of practice, is present”.
Where such a practitioner is not present, propofol must not be used.
7.30 has been told nurses at The Canberra Hospital did not receive specific training or accreditation for sedation from the anaesthesia department.
The practice is known as Endoscopist-Directed-Nurse-Administered-Propofol-Sedation (EDNAPS).
‘This is very dangerous practice’
EDNAPS is common in some parts of Europe and the United States but is not accepted practice in Australia, due to different levels of relevant nurse-training and concerns about safety.
President of the Australian Society of Anaesthetists, associate professor David Scott, whose role is to represent anaesthetists, said it was misleading to refer to EDNAPS as “sedation” because the combination of fentanyl, midazolam and propofol could quickly progress to general anaesthesia.