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I'm against most protocols.  In an effort to encompass all like situations, they really fit none specifically.  If you're an ED MD then you should be able to think your way thru a problem, specifically that problem and not depend on a cookbook.  My experience with giving nurses any protocols like you've mentioned have all had problems.  I agree with your committee.


-----Original Message-----
>From: "Givens, Timothy" <[log in to unmask]>
>Sent: Apr 16, 2010 1:37 PM
>To: [log in to unmask]
>Subject: Use of protocols & pathways in the ED
>
>For the group:
>
>Have any of you encountered resistance to the use/implementation of treatment protocols in the ED?  Our hospital P&T committee recently placed a moratorium on the approval of new or revised protocols house-wide while they engage in a philosophical debate about the appropriate use of protocols in general.  Their objection to some recently submitted triage protocols (decadron for croupers, zofran for vomiting patients, etc.) was that it required nurses in triage to diagnose and or prescribe medications, and this violated the scope of nursing practice.  I am interested to hear what the group's opinions in this regard are--positive and negative.  As in everything, we are trying to balance efficiency, throughput, and patient satisfaction with safety concerns, and I'm certain this is the crux of the issue.  What do you think?
>
>Tim Givens, MD
>Medical Director, Pediatric Emergency Department
>The Children's Hospital, Denver
>Acting Section Chief, Section of Emergency Medicine
>Department of Pediatrics
>University of Colorado, Denver
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Fergus Thornton
read my blog @ http://docdownunder.wordpress.com

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
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