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Flashcards in NMB Monitoring Deck (30):
1

What is TOF?

Train of Four

2

What two Hz levels are usually used for tetany?

50 Hz and 100 Hz

3

What is most common NMBM sites?

Unlar nerve

4

What is correct way to orient cathodes when placing them on body?

Red closest to heart, black most distal

5

Name 2 other NMBM sites other than ulnar nerve?

Facial nerve on side of face between ear and eye

Posterior tibial nerve on inside of ankle near medial malleolous

6

What is unique about facial nerve placement?

Red cathode is placed more superior (away from heart) and black more inferior (closer to heart)

7

What is motion that is observed when checking facial nerve using NMBM?

Eyebrow will twitch

8

How many twitches are seen when at least 75% of receptors are blocked?

3 twitches

9

What percent of receptors are blocked when 4 twitches are observed?

0-75% of receptors

10

What percent of receptors are blocked when 2 twitches are seen?

80%

11

How many twitches would you expect when 90% of receptors are blocked?

1 twitch

12

Explain what you would observe when 100% of receptors are blocked

0 twitches and with no tetany

13

How many twitches must be observed before you can give reversals?

At least 1

14

What drug produces fasiculations?

Succinycholine

15

What are fasiculations?

Uncontrolled muscle twitches throughout entire body seen under the skin

16

What is the unit of measure on NMB stimulator?

mA

17

Which NMB agent has shortest duration of action?

Succinylcholine

18

What NMB agent has longest duration?

Pancuronium

19

What is a non depolarizing NMB agent?

Roc, Vec, Nimbex, Panc

20

What is the depolarizing NMB agent used in anesthesia?

Succinylcholine

21

Define sensory threshold

Threshold at which when pt is awake, produces a facial reaction when NMB monitor is turned on

22

What is the motor threshold?

Threshold at which produces a motor twitch from NMB stimulation after pt has gone to sleep but before muscle relaxant has been administered

23

How many mA should be administered to determine sensory threshold?

4-5 mA

24

How many mA are administerd when determining motor threshold?

15-20 mA

25

What is the supermaximal stimulus?

25 mA above motor threshold

26

What physiologic significant variable effects stimulation thresholds?

Temperature

27

When the nerve stimulator is placed on the ulnar nerve, the actions of which muscle(s) is/are being monitored?

Flexor Carpi Ulnaris and Adductor Pollicis

28

What causes prolonged neuromuscular blockade following administration of succinycholine?

Pseudocholinesterase deficiancy

 

29

How do you offset the fasciculations associated with succinycholine?

5 mg Rocuronium

30

List order of muscles affected by a neuromuscular blockade?

-- Laryngeal adductors

-- Diaphragm

-- Orbicularis oculi

-- Rectus abdominus

-- Adductor pollicis