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


Ketamine, Precedex, Emergence Delirium, PTSD, Combat Veteran


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.

Download Full Text Above

Included in

Nursing Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.