Storage and Access of Paralytics for Emergency Use

PLEASE NOTE:   Posts made to this forum should not be considered as the expressed opinions of, nor should be considered endorsed by, the Medication Safety Officer’s Society (MSOS) or the Institute for Safe Medication Practices (ISMP). 

Make sure your email is up-to-date
In order to continue to receive updates from MSOS, as well as forum posts and other valuable information as a member of MSOS, please be sure to update your email address with us, whenever it changes. If you need assistance doing so, please send an email to jgold@ismp.org

4 posts / 0 new
Last post
Abby Puckett
Abby Puckett's picture
Offline
Last seen: 1 week 2 days ago
Joined: 06/25/2021 - 10:08
Storage and Access of Paralytics for Emergency Use

Hello everyone,

I'm from a 300 bed, community hospital and am looking to see how other similar sized hospitals store paralytics for emergency use (ADC, physical kits, virtual kits, ect.) and the process of retrieval in code type situations. We currently do not have adequate pharmacy staff to respond to codes and provide medications for RSI 24/7.

We currently have rocuronium and succinylcholine loaded in our Pyxis machines in all ICU units that ICU nurses are able to override. As a safer option, we developed a "virtual kit" that ICU nurses can also override to pull in emergency situations. The Pyxis kit must be overridden under a specific patient, and it opens each component of the kit (etomidate, succhyncoline, and rocuronium) one item at a time with pop-up alerts for each drug.

Nurses have expressed appreciation of the virtual kit from a safety perspective, but it has proven to be very time consuming especially for codes that are called on med surg units where paralytics are not stored in the pyxis machines. What processes have organizations implemented to ensure safe but timely RSI drug access in code type situations?

Thanks,
Abby Puckett