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BACKGROUND Neuromuscular blockade is a frequently used therapy in the ICU. However, recent reports of prolonged paralysis and general muscular weakness in patients treated with this procedure have raised concerns about its use in intensive care. OBJECTIVE The purpose of this study was to assess current monitoring practices of nurses who care for patients treated with neuromuscular blockade. METHODS In January 1995, questionnaires were mailed to a random national sample of 2000 critical care nurses. Of the 2000 questionnaires mailed, 744 were returned. RESULTS The number of patients per month who were treated with neuromuscular blockade in ICU settings ranged from 0 to 75 (mean = 6.82, SD = 9.15). For each patient, the average number of days of blockade ranged from less than 1 to 63 (mean = 4.12, SD = 3.36). The most common indications for neuromuscular blockade were to assist in mechanical ventilation, reduce oxygen consumption, and treat agitation. Only 41% of respondents (n = 306) reported using train-of-four stimuli and a peripheral nerve stimulator to monitor patients. Depth of neuromuscular blockade was routinely monitored by using clinical assessment (31%), a peripheral nerve stimulator (16%), or both (52%). CONCLUSIONS Among the respondents, variations existed in monitoring practices and in the use of peripheral nerve stimulators, including the frequency of monitoring and use of the baseline milliamperage. Appropriate monitoring and titration of neuromuscular blocking agents by ICU nurses may aid in preventing adverse effects, including the potential for prolonged neuromuscular blockade. The existing variations in practice may affect patients' outcomes.
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
November 1988,
Anaesthesia and intensive care,
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
May 1984,
Anesthesiology,
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
June 1995,
Critical care nurse,
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
November 1987,
Anaesthesia and intensive care,
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
September 1988,
Canadian journal of anaesthesia = Journal canadien d'anesthesie,
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
January 1988,
Acta anaesthesiologica Belgica,
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
June 2006,
Anaesthesia,
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
March 2004,
Journal of clinical anesthesia,
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
January 1993,
Regional anesthesia,
R Kleinpell, and
C Bedrosian, and
L McCormick, and
M Kremer, and
L Bujalski, and
R Bronsted
November 1993,
Chest,
