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American Journal of Critical Care. 2009;18: 592-588 doi:10.4037/ajcc2009572
Copyright © 2009 by the American Association of Critical-Care Nurses.
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Cases of Note features peer-reviewed case reports and case series that document clinically relevant findings from critical and high acuity care environments. Cases that illuminate a clinical diagnosis or a management issue in the treatment of critically and acutely ill patients and include discussion of the patient’s experience with the illness or intervention are encouraged. Proposals for future Cases of Note articles may be e-mailed to ajcc{at}aacn.org.

Prolonged Paralysis and Apnea After Receiving a Neuromuscular Blocking Agent: What Nurses Should Know

By Kathryn S. Jaramillo, RN, BSN, Elizabeth Scruth, RN, MN, MPH, CCNS, CCRN and Eugene Cheng, MD. Kathryn S. Jaramillo is a graduate student in the cardiovascular genomics clinical nurse specialist program in the School of Nursing, University of California, San Francisco. Elizabeth Scruth is a critical care clinical nurse specialist in the Department of Educational Services and Eugene Cheng is chief of intensivists in the Department of Anesthesia at Kaiser Permanente Medical Center, San Jose, California.

Corresponding author: Kathryn S. Jaramillo, RN, BSN, University of California, San Francisco, School of Nursing, Department of Physiological Nursing, 2 Koret Way, Box 0610, San Francisco, CA 94143-1610 (e-mail: kaye.jaramillo{at}gmail.com).

After receiving mivacurium, a short-acting neuromuscular blocking agent used for intubation before surgery, a patient experienced prolonged paralysis and prolonged apnea that required ventilator support. Although this complication is rare, all critical care nurses should be aware of it so they can be competent in managing and providing holistic and comprehensive nursing care to the patient and the patient’s family. Although this complication has been documented in the anesthesia literature, it has received little mention in critical care nursing journals.






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Copyright © 2009 by the American Association of Critical-Care Nurses.