GE CARESCAPE - NMT cautions; NMT measurement limitations; NMT points to note; Checking the NMT measurement

Neuromusculartransmission
NMTcautions
CAUTION
AlwaysstoptheNMTmeasurementbeforehandlingthe
stimulatingelectrodes.
CAUTION
Neversubjectapatientwithanimplantedelectronicdeviceto
electricalstimulationwithoutconsultingamedicalspecialist
rst.
CAUTION
Ifusedincloseproximitytoshortwaveormicrowavetherapy
equipment,stimulatoroutputmaybecomeunstable.
NMTmeasurementlimitations
●ThismeasurementisnotavailableintheNICUsoftwarepackage.
●NMTmeasurementisnotindicatedforpediatricpatientsweighinglessthan5
kg(11lbs).
●PediatricMechanoSensorisvalidatedforchildrenweighing5to20kg(11to44lbs).
●Electrosurgerymaycauseincorrectmeasurementresults.
●NMTmeasurementisnotindicatedforpatientswithknownabnormalfunctionof
neuromuscularjunction.
NMTpointstonote
●Startmonitoringbeforetheadministrationofamusclerelaxantdrug(butafterthe
inductionofsleepingeneralanesthesia)topreventvoluntarymusclecontraction
andtensionfrominterferingwiththereferencesearch.
●Whenplacingtheelectrodes,makesurethattheydonottoucheachother.
●Donotplaceelectrodesonareaswithexcessivebodyhairorlesions.
●Iftheelectrodesareplacedincorrectly,wrongnervesarestimulatedandthis
causeswrongmuscleresponse.
●Whenmultiplenervesarestimulated,themeasuredresponsemaybeaffected
byelectricalactivityofothermuscles.
●Ifthestimulationelectrodesareplacedveryclosetothepalmofthehand,the
musclesarestimulateddirectlybythestimulationpulses.
●Donotapplystimulationacrossorthroughthehead,directlyontheeyes,covering
themouth,onthefrontofneck(especiallyoverthecarotidsinus),orfromelectrodes
placedonthechestandtheupperbackorcrossingovertheheart.
●Ifthecurrentistoostrong,itmaystimulatethemusclestoomuch.
●Movingortouchingthepatientduringmeasurementmaycauseincorrectresults.
●Forsafeextubation,theTOF%shouldbehigherthan90.Alsoassessotherclinical
signs.
CheckingtheNMTmeasurement
1.Alwayschecktheelectrodequality.
362CARESCAPEModularMonitors2062971-001