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Thank you all for your responses.  From what I can tell, most of you are using 0.25 mg/kg in your IN versed dosing.  I have found reports in retrospective trials of procedural sedation/anxiolysis of doses from 0.25 mg/kg to 0.8 mg/kg.  The largest max dose found was 10 mg total.  Even in these higher doses it seemed the safety profile was outstanding.  

Do any of you have experience with dosing on the higher end?  Do you personally have a max dose you use by policy or practice?  In a busy community ED where throughput is stressed, it seems that the 20 minutes or more improvement in the decreased stay surrounding the procedure (not including the time it takes for IV administration/nursing resources) and the decreased trauma to parents minus the IV it seems that versed is a viable alternative.  

Thank you again for all your thoughts.

Paul Frandsen, MD 

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