20 Monitoring NMT
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1
Place the distal electrode near the wrist.
2 Place the proximal electrode 2 to 3 cm proximal to the distal electrode.
3 Attach the Black cable clamp cable to the distal electrode, (see figure above).
4 Attach the Red cable clamp cable to the proximal electrode, (see figure above).
5 Place and affix the transducer with a large flat side against the palmar side of the thumb. The cable
should be attached in such a way that it does not 'pull' at the transducer and that movement of the
thumb is not obstructed. The more distal the transducer is placed on the thumb, the stronger the
acceleration signal.
CAUTION
Make sure that the lead wires cannot come into contact with external pacemaker or catheter wires.
Arm Position
The arm used for the NMT measurement, should be kept immobile during the whole procedure.
Taking NMT Measurements
NOTE
Both the NMT calibration and NMT measurement cannot be started:
– When the parameter (NMT) is switched off
– During the recovery phase after a measurement.
– During an ongoing automatic measurement cycle.
– During an ongoing calibration
– When error conditions have been detected.
– When no patient cable is connected.
Calibrating the NMT Measurement
With the NMT calibration the supramaximal stimulation current is determined and the reference
twitch is set to 100%. The reference twitch is the twitch at the supramaximal stimulation current when
the patient is not paralyzed. This must be done prior to administration of Neuromuscular Blocking
Agents (NMBA).
If the NMT Module is unable to establish a reference twitch, it uses an internal reference value for
single-twitch measurements.
NOTE
It is recommended that the patient be anesthetized before setting up the calibration twitch as nerve
stimulation can be painful.
Starting Calibration
1 Either press the NMT key on the module, or select the numeric on the screen to enter the Setup
NMT
window.
2 Select Start Cal.
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