Cataracts – PO sedation, no IV, and some BMIs over 50

[hmccarter10]

[hmccarter10]

A surgeon is requesting PO versed for sedation (his order), and no IV for his cataracts. He is also wanting discretion on BMI over 50. Private practice. CRNA only. He is very fast and smooth – approx 6 min cataracts.

The main issue is that a lot of these patients are very poorly managed with a lot of comorbities.

He says he knows other cataract surgeons doing it this way in FL.

What are some ideas for guidelines that we can put into place while also trying to accommodate his requests? How would you handle this situation?