System improvements for the use of neuromuscular blocking agents

Neuromuscular blocking agents (NMBA) are commonly used in the emergency department, operating room, and intensive care unit. After two separate incidents in which NMBA were not immediately available in an emergency, a quality assurance process was used to identify the method for controlling distribution and availability of NMBA use in the emergency department. The new system uses a pharmacy-stocked paralytic agent box and transport bag. The benefits of this system have included (1) 100% availability of NMBA when needed in the emergency department, (2) better availability of supplies and ease in transporting for times when a patient needs to be moved within the hospital, and (3) more efficient billing and tracking of controlled substances by the pharmacy department.