Prescribed Drugs For Sedation For Hospital Scans And Procedures

Our policy

After careful consideration, we have decided no longer to prescribe diazepam for patients having MRI scans or other investigative procedures. This is not a decision we took lightly; we have a duty of care to provide safe, consistent, and appropriate care for our patients.  We hope the reasons outlined below help to explain our main concerns:

• Small doses of benzodiazepines such at 2mg diazepam are likely to be sub-therapeutic for most adults for any effective sedation. Conversely in a small number of people an opposite response is seen in patients, with even very small doses causing greatly increased agitation.
• A patient may take a sedative ‘an hour’ before their assumed procedure, to then attend the hospital to find their procedure has been delayed, therefore the timing of the drug effect would be suboptimal.
• GPs are not regularly involved, skilled, trained or appraised in sedation skills (and are not present when the patient has the procedure)
• All hospital consultants, both those requesting imaging and those providing it, have access to the same prescribing abilities as GPs. If a patient needs a certain medication to enable an investigation to go ahead, hospital doctors can provide a prescription, either through the hospital pharmacy or a hospital FP10.
• Sedated patients should be regularly monitored, and we have been made aware of a case where a GP provided sedative was given, the patient not monitored, and subsequently had a respiratory arrest in an MRI machine.
• The Royal College of Radiologists‘ own guidelines on sedation for imaging makes no mention of GP involvement or provision of low dose anxiolytics and stresses the importance of experienced well-trained staff involved and the monitoring of sedated patients