Date of Award

Spring 5-8-2020

Document Type

DNP Project

Project Team Faculty Member

Dr. Mary Zerlan, DNP, CRNA

Project Team Faculty Member

Dr. Frank Lyerla, PhD, RN, FHIMSS

Project Team Faculty Member

Danny Geib, MS, CRNA

Keywords

Ketamine, Precedex, Emergence Delirium, PTSD, Combat Veteran

Abstract

Emergence Delirium incidences in the combat veteran population warrant unique anesthetic considerations. Examples of these considerations include the exclusion of a benzodiazepine and the use of low dose Ketamine or Precedex infusions. Researching these considerations, an anesthetic decision tree coupled with a screening questionnaire was developed and implemented in a hospital in Southern Illinois. The tool was developed based on a thorough literature review and a need to condense this information into a working knowledge for clinical application. Implementation of the project included staff education on the tool and the management of Emergence Delirium by using Ketamine and Precedex. A brief pre-test was given and then the provider was able to read the education material followed by a post-test. Results indicated an overall starting score of 80.6% that was raised to 95.1% following the education session. The post-implementation survey had eight responses in which all reported anesthetizing a combat veteran after the project implementation. Of the respondents, seven included using the project decision tree and none reported complications or Emergence Delirium. One respondent reported not using the protocol due to anesthetic plan conflict with another provider. This project positively improved patient outcomes while brining a researched anesthesia protocol into practice.

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