Dear Nurses

Saturday, April 28, 2007

WHAT IF YOUR PATIENT HAD AN NMB ORDER

Updated 7/25



Scenario: Nick is in the ICU, with a diagnosis of
ARDS (Adult Respiratory Distress Syndrome).

ARDS is a life threatening condition, brought on by
fluid buildup in the lungs. As the air sacs fill with fluid,
air exchange and oxygenation become difficult.

White patches on the lungs are seen on X-Ray. The
term"white out"
is sometimes used to describe the
damaged lungs.
         
Mehanical ventilation becomes necessary, to assist
 with the workload 
of breathing. Breath sounds are
decreased as ventilation of lung tissue 
becomes difficult.

This complex illness, may be triggered by a number
of conditions.
Causes include, but are not confined to: 
- pneumonia, near drowning
- massive blood transfusions
- pancreatitis, trauma and sepsis .


Management of the patient in ARDS is done in the ICU.

Neuroblockades are paralysing agents. They are sometimes
used in the Critical Care Setting or in the OR. Patients who
have traumatic injuries and require ventilatory support for
lung problems such as ARDS, may require NMB.

When patients are put to sleep in the OR, NMBs are also used.
They cause paralysis of all the muscles in the body.
Here are some helpful hints :
- Follow MD orders
- Patients should NEVER be given NMBs, without Ventilatory support.
- Patients need monitoring if Neuromuscular Blockades are being used.
- SEDATION should always accompany the use of NMB drugs.
Patients who are given NMBs without sedation have related
terrible experiences. Some felt like they were buried alive.



Learn more about : ARDS, DVT and PE

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