Clinical Use of Neuromuscular Blocking Agents
Course Overview
Neuromuscular blocking agents (drugs that paralyze skeletal muscle) have been used in anesthesia since the 1930s. Their use in the intensive care unit, emergency department, and prehospital care (e.g., ground and air ambulances) is somewhat more recent, though still well-established. Despite the fact that these drugs are commonly administered to critically ill patients, many practitioners have only the most rudimentary knowledge regarding the proper selection of these agents, their broad classifications, their dosages, the monitoring technique necessary for their use, and other crucial aspects of this class of drugs. Indeed, a number of potentially lethal side effects from the acute or chronic administration of these agents may occur, resulting in significantly increased morbidity and mortality among patients receiving them.
Learning Outcomes
Upon the completion of this course, the learner should be able to:
- Review the pertinent history surrounding the discovery and early administration of neuromuscular blocking agents.
- Outline the anatomy and physiology of the neuromuscular junction.
- Identify commonly used neuromuscular blockers.
- Discuss the use and effects of benzylisoquinolinium nondepolarizing neuromuscular blocking agents.
- Describe the use and effects of amino steroid nondepolarizing neuromuscular blockers.
- Identify the crucial effects and side effects of succinylcholine, listing both relative and absolute contraindications to its use.
- Analyze approaches to monitoring neuromuscular blockade.
- Evaluate the effects and use of traditional agents used to reverse neuromuscular blockade.
- Discuss the reversal agent sugammadex.
- Analyze the role of neuromuscular blockers in various patient populations.
About the Author/Presenter
Richard E. Haas, BSN, MSN, EdM, PhD, CRNA, LTC US Army Nurse Corps (Retired), is a retired nurse anesthetist and prehospital registered nurse (instructor) who has published extensively in various areas of healthcare research while providing clinical care in arenas ranging from academic medical centers to austere environments in the third world during both wartime and peacetime. He has a bachelor’s degree in nursing from Georgetown University, Master’s degrees in education (Boston University) and nursing specializing in anesthesia (State University of New York in Buffalo and U.S. Army), and a PhD from the University of South Carolina. He is a retired lieutenant colonel in the U.S. Army Nurse Corps. He has taught nursing anesthesia, pharmacology, and physiology; mentored students in doctoral programs; and used advanced patient simulation to train students. Dr. Haas has worked in clinical, administrative, education, and research roles. He continues to work as an independent consultant, while taking more time to enjoy life with his wife of nearly 50 years and their children and grandchildren.
Audience/Accreditations and Approvals
TRC Healthcare/ NetCE
In support of improving patient care, this activity has been planned and implemented by TRC Healthcare/ NetCE. TRC Healthcare/NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This course is designed for the following healthcare professions (select your profession for details):
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