I know this topic was posted last year but I wanted to see if there are any organizations that have moved to storing NMBs in lidded bins in anesthesia carts. I reached out directly to ISMP and they responded that the intent of BPR #7 is that NMBs should be in lidded bins/ boxes wherever they are stored within an organization, including the OR. We currently have rocuronium vials stored in lidded bins but we do not have enough room to store succinylcholine syringes in lidded bins. I would be grateful to hear from anyone who has been successful with this!

How are institutions handling ISMP Best Practice #7 regarding storage of neuromuscular blockers in the following locations?
1. Anesthesia ADM
2. Non technology stock carts - example: locked airway carts
3. Code carts

Thanks -
Maria Cumpston, PharmD, CPPS
Medication Safety Officer
WVU Medicine

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.