I saw this last posted in 2014, but wanted to re-address given the heightened focus on NMBs. To comply with the ISMP recommendations of segregating NMBs in an RSI kit in patient care areas, we have standardized our RSI kits in the ICU and ED. We store them in the refrigerator both in the pharmacy and patient care area Pyxis'. These kits go in and out of the fridge and what I am wondering from this group is:

1) Do you store RSI kits at room temperature with short dating for the refrigerated medications?
2) If you store in the refrigerator, do you have a limit on the number of times meds can be put in and taken out of the refrigerator? How do you keep track of this?
3) Do your RSI kits in the ICU and ED contain the same medications?

Our kit contents are: etomidate, succinycholine, vecuronium, rocuronium cisatracurium, lidocaine, phenylephrine. Cisatracurium would be our challenge from a waste perspective with room temp dating.

Thank you in advance for your thoughts and shared experience!

Chelsea Aidala, PharmD, BCPS
Medication Safety Officer
Swedish Medical Center (Colorado)