Neuromuscular monitoring by intensive care nurses: comparison of acceleromyography and tactile assessment.
We have compared tactile assessment of the train-of-four (TOF) count and TOF ratio by nursing staff, with measurements made by a new acceleromyographic monitor, the TOF-Watch. We assessed neuromuscular block in 30 sedated intensive care patients receiving a continuous infusion of atracurium. Five nurses made a tactile assessment of neuromuscular block in each patient within a 5-min period. Each assessment was paired with a blinded TOF-Watch measurement. The nurses were accurate in assessing twitch count in 55% of measurements and they tended to overestimate the degree of block using tactile assessment of TOF ratio.
Greer
R
R
Intensive Care Unit, Manchester Royal Infirmary.
Harper
N J
NJ
Pearson
A J
AJ
D000328:Adult; D001279:Atracurium / Q000494:pharmacology; D003422:Critical Care / Q000379:methods*; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D009213:Myography / Q000379:methods; D019148:Neuromuscular Blockade; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology; D009732:Nursing Care / Q000379:methods*; D014110:Touch
D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium