Download vecuronium bromide - TransCare Ambulance

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Transcript
VECURONIUM BROMIDE
Familiarization Training
General Information
• Vecuronium is a non-depolarizing
neuromuscular blocking agent, preventing
acetylcholine from binding to muscle
receptors on the end plate, thus resulting in
compete paralysis.
General Information
• Onset of action is within about one minute
after administration.
• Effects persist between 25 and 35 minutes.
Question: Why are the onset and duration of
this medication important to us specifically?
INDICATIONS
• Maintenance of chemical paralysis for patients
on a ventilator during inter-facility transport.
Question: What are the other indications for this
drug per TransCare protocols.
PRECAUTIONS
• ET tube placement should be assessed and
documented q 10min.
• Continuous end tidal CO2 monitoring and
SaO2 are to be used to ensure ET patency.*
• Assess and treat for under-sedation:
– Tachycardia
– Hypertension
– Lacrimation
PRECAUTIONS CONTINUED
– Diaphoresis
– Twitching or muscle spasm
Remember paralytics do not obtund consciousness
or alter patients pain threshold. Administration of
sedatives and analgesics may be required.
Typically Versed is used for sedation and Fentanyl
for analgesia.
Make sure you have orders for both!!
ADMINISTRATION/DOSING
• DOSING IS WEIGHT BASED! Make sure you
get an accurate weight prior to departure!
• Medication must be reconstituted prior to
administration. Use 10ml sterile water. NOTE:
Make sure to use sterile water that is labeled
“for injection”.
• Adult Dose: 0.08 – 0.1 mg/kg IVP
• Pediatric Dose: Same but greater recovery
time.
ADMINISTRATION/DOSING
• Drug is supplied as 10mg/10ml powder form
vial and again must be reconstitiuted.
CONTRAINDICATIONS/CAUTIONS
• As with all medications, a hypersensitivity to
this drug.
• List of Cautions
ADVERSE REACTIONS
Although protocol lists no side effects, here are
some adverse reactions
• Prolonged Paralysis
• Respiratory Depression
• Apnea
• Anaphylaxis
• Bronchospasm
CONCLUSION
• Being familiar with this protocol/waiver is a big
part of being comfortable with his medication.
• Monitor your patient carefully and check and recheck vent settings and tube placement regularly.
• Get a weight from the hospital.
• If you are uncomfortable or unfamiliar with any
aspect of this medication or vent equipment call
operations manager on duty