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20Monitoring NMT
Neuro Muscular Transmission (NMT) and its measurement enables the evaluation of muscle
relaxation of patients under Neuromuscular Block by measuring the strength of muscle reaction after
electrically stimulating the dedicated motor nerve. The NMT Monitor electrodes are placed on the
patients skin over the ulnar nerve, a controllable current source delivers stimulation pulses to two skin
surface electrodes for the nerve stimulation, the muscle response is measured with an acceleration
sensor.
WARNING
The NMT measurement may not be used for neonatal patients and is therefore not supported in
the neonatal mode.
NMT stimulation current pulses may interfere with other sensitive equipment, for example,
implanted cardiac pacemakers. Do not use the NMT measurement on patients with implanted medical
devices unless so directed by a medical specialist.
Simultaneous use of the NMT with high frequency electrosurgical equipment may in unusual
circumstances result in burns at the stimulation site and can also adversely affect measurement
accuracy.
Do not use the NMT in close proximity to shortwave or microtherapy devices, there is a risk of
adversely affecting the NMT measurement.
Explosion Hazard: Do not use in the presence of flammable anesthetics or gases, such as a
flammable anesthetic mixture with air, oxygen or nitrous oxide. Use of the device in such an
environment may present an explosion hazard.
Never apply the electrodes trans-thoracically (across the chest) or transcerebrally (across the head),
there is a risk of seriously injuring the patient. Apply the stimulation electrodes close together as
described in the Instructions for Use.
Never apply electrodes to patients in areas where inflammation or injury is evident.
When you are connecting the electrodes or the patient cable, make sure that the connectors do not,
and cannot, come into contact with other conductive parts, or with earth.
Never touch the electrodes unless the stimulation has been stopped.
Patients with nerve damage or other neuromuscular problems may not respond properly to
stimulation. The NMT measurement may show unusual patterns when monitoring muscle paralysis in
these patients.
After repositioning the patient, check that the sensor is still applied and can move freely.
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