We recently had a request for rocuronium to be used in the Allergy clinic for patient sensitivity testing. As I found out, there is primary literature that speaks to allergy testing of NMBs when a patient has anaphylaxis to one of these agents since there is cross-reactivity. I prefer to have pharmacy own this process, to minimize the risk of a NMB used in clinic setting, but would like to hear how others are handling this type of request.

1. Has your allergy clinic made a request for a NMB for skin testing?
2. Who is preparing it - pharmacy or clinic?
3. What other safeguards are in place for clinic administration of the dilution? e.g. more than labels?