The Food and Drug Administration, drug manufacturers, and critical care experts recommend using peripheral nerve stimulators (PNSs) to monitor depth of blockade when administering neuromuscular blocking agents (NMBAs). This study evaluates critical care nurses' practices regarding use of PNSs, identifies problems associated with their use, and determines other methods of assessing level of blockade to guide medication titration. Of respondents to a survey, 75% reported administering NMBAs for long-term use in their critically ill patients. In facilities using NMBAs, 63% monitored blockade level with a PNS. Because of practice disparities and monitoring problems, further education and research are needed to ensure adequate monitoring during NMBA administration.
Assistant Professor Houston Baptist University College of Nursing Houston, Texas (Foster)
Senior Research Nurse Department of Critical Care The University of Texas M.D. Anderson Cancer Center Houston, Texas (Kish)
Advanced Practice Nurse Department of Neurosurgery The University of Texas M.D. Anderson Cancer Center Houston, Texas (Keenan)
This work was supported by a grant provided by the American Association of Critical Care Nurses Houston–Gulf Coast chapter.
Source: Portions of this article have been adapted with permission from JGW Foster, SK Kish, and CH Keenan, A National Survey of Critical Care Nurses' Practices Related to Administration of Neuromuscular Blocking Agents, American Journal of Critical Care, Vol 10, No 3, pp 141–144, © 2001, American Association of Critical Care Nurses.