Q: What precaution a clinician should take while using propofol in sedated intubated COVID-19 patients?
Answer: As standard propofol has been supplied in a bottle with a dose of 10 mg/ml. COVID-19 caused an exponentially high demand for propofol across the USA due to an unexpectedly high number of intubated patients. FDA has allowed a temporary relaxation in this dose preparation up to 20 mg/mL (2 percent dose). Although pharmacists in ICU across the USA are very involved in the management of COVID patients, clinicians are equally liable to check the infusing drips at the bedside. An unintentional overdose of propofol can be fatal in these sets of already fragile patients. Automated alerts on EMR should be updated/applied as a safety measure.
US Food and Drug Administration. Fact sheet for healthcare providers: Emergency use authorization (EUA) of Fresenius Propoven (propofol) 2% emulsion. https://www.fda.gov/media/137889/download (Accessed on November 5, 2020).