Frequently Asked Questions

Table of Contents

1. What is NAPS?
2. What are the benefits of NAPS over conventional sedation?
3. Is NAPS safe?
4. How long does it take to recover from NAPS?
5. What are mechanics of the nurse administered propofol
   sedation course?
6. Have you had any issues with the State Board of Nursing and RNs administering what is usually considered an “anesthesia” drug?
7. What do the Boards of Nursing across the nation say about nurses administering propofol for endoscopy?
8. Do you certify doctors and nurses in the use of NAPS?
9. How does the propofol sedation program fit into the ASA and Joint Commission definitions of Light/Moderate/Deep Sedation? Do your patients still meet the criteria for Moderate Sedation?

What is NAPS?

Nurse Administered Propofol Sedation is a sedation technique for colonoscopy, EDGs, and liver biopsies. In N.A.P.S., the patient is sedated with a moderate initial dose of Diprivan (propofol) and sedation is maintained during the procedure via the administration of very small doses as needed.

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What are the benefits of NAPS over conventional sedation?

The benefits are many:

• Every exam is painless and there is total amnesia.

• Patients are discharged extremely quickly, usually within 15 minutes and sometimes faster.

• Patients may quickly return to meaningful quality of life activity, including work.

• The technicians and nurses are noticeably more relaxed and better able to focus on their individual tasks.

• Patients have a much better memory of the findings shared by the physician after the procedure.

For more advantages, click here

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Is NAPS safe?

Nurse Administered Propofol Sedation has been employed in over 28,000 procedures as of December 2004.  There has been a superlative safety record, no mortality of any cause, and a perfect record of painless exams with total amnesia. 

For more on our "safety net," click here.

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How long does it take to recover from NAPS?

The average discharge time is 15 minutes from the completion of the procedure.  Most patients can return to full work or leisure activity within two hours.

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What are mechanics of the nurse administered propofol
sedation course?

Arrive on a Tuesday, begin training at 0700 Wednesday morning, and depart Thursday afternoon, ideally after 1400 hr. Nurses may stay through Friday or return on another occasion  without additional charge.

• Probable interactive didactic session over excellent food Wednesday evening.
• Ideally, the visiting team should consist of one endoscopist and two nurses.
• After three to six months, one of us will observe your nurse administered propofol sedation program in your facility.
• Other aspects of the package are mentioned on the first and second pages of our website, www.drnaps.org.
• Live cases will be supplemented by videos.

Call 541-779-5475 or email val@drnaps.org for an appointment or additional information.

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Have you had any issues with the State Board of Nursing and RNs administering what is usually considered an “anesthesia” drug?

In the Fall of 1998, two physicians in our community expressed alarm at the protocol developed by Dr. Robert McIntyre, three nurses, and me. I convinced the Board that this was safe and a breakthrough. They agreed a guaranteed painless method of sedation would be of great societal value and that colon cancer is the real enemy. They charged us to be prudent and vigilant. Incidentally, the two nay saying physicians, a gastroenterologist and an anesthesiologist, eventually had NAPS for their endoscopic procedures.

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What do the Boards of Nursing across the nation say about nurses administering propofol for endoscopy?

Good question. We are currently writing all fifty boards plus the District of Columbia. We anticipate helping them update their policies in these times of progress.

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Do you certify doctors and nurses in the use of NAPS?

We believe our curriculum is the first of its kind. We are not endorsed yet by any institution, board, or overseer. Our over 28,000 patient tally (as of December, 2004) is to our knowledge the world’s largest experience. Our syllabus has received praise from all who’ve seen it. Of our nine physicians and forty-two nurses, we’ve had no failures. National presentations have been in Phoenix, San Diego, Atlanta, San Francisco, Orlando, Knoxville, New York City and Osaka, Japan. Before a team leaves our facilities, they will pass a competency exam and we will give them a certificate of attendance.

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How does the propofol sedation program fit into the ASA and Joint Commission definitions of Light/Moderate/Deep Sedation? Do your patients still meet the criteria for Moderate Sedation?

I like to visualize sedation as a continuum though I understand the value of the semantic division of sedation into light, moderate, and deep. Frequently on the form at one of our three facilities which asks the physician in advance his sedation intention for the patient who is next, I will cross out “deep with propofol” and write in “just enough.” I can achieve moderate sedation with propofol; I call this zone “befuddlement.” It is the appropriate level in some cases, say an esophageal meat impaction.

My understanding of ASA/JCAHO requirements is that any physician using any sedation should be skilled in rescue, in case the intention to go light or moderate goes awry.

My understanding also is that it’s okay for the non-anesthesia specialist to use deep sedation as long as he/she is credentialed by the individual institution.

We’d like to show you NAPS, the free-hand method of “just enough.” My bias is that though there will be “smart machines” in the near future, NAPS is better than an infusion pump. I think deep sedation with propofol with the “just enough” method is safer than traditional sedation.

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Copyright © 2003  [DRNAPS.ORG]. All rights reserved.
Revised: 12/12/04.