Hi All,

Does your org affix paralytic warning auxiliary labels to NMB vials that contain the warning on the manufacturer cap?

We are seeing more providers wanting to titrate paralytic agents to "ventilator synchrony", although our current titration goal parameter is TOF.

If your policy/practice allows it, could you share how you objectively define ventilator synchrony at your institution?

Where does that definition live, in policy, or is part of every medication order (e.g. default order comments)? If you are willing to share your policy or screen shots, that would be very helpful!

Thank you.
Daniel

We are seeing more providers wanting to titrate paralytic agents to "ventilator synchrony". Our current titration goal parameter is TOF. What are your default titration goal parameters for neuromuscular blockers?

a) Train of Four
b) Ventilator synchrony
c) other

If titrating to ventilator synchrony, how do you define and measure it? Any additional insight you can provide is appreciated.

Thank you.

Daniel Kudryashov
Keck Medicine of USC

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