How often is Vecuronium given in the ICU setting?

[Turtle in scrubs]

With the RaDonda Vaught trial underway I'm curious how often an ICU nurse, on the unit, gives Vecuronium.  Of course ICU's treat different patient populations and different acuity patients, but trying to get a rough idea. 

[MaxAttack, BSN, RN]

Wow I had no idea about this trial. That could be a whole thread of its own..

In any case I'm assuming you're talking about any paralytics, not just vec? I've only used vecuronium once or twice. Rocuronium is the go-to for RSI and cisatracurium is the go-to for continuous infusions where I'm at. I'll handle one of these probably once a month or so.

[Rose_Queen, BSN, MSN, RN]

8 minutes ago, MaxAttack said:

Wow I had no idea about this trial. That could be a whole thread of its own..

there are actually several threads devoted to this situation in General Nursing

[Rose_Queen, BSN, MSN, RN]

Moved to general nursing as this is where other threads related to Radonda Vaught are.

[Okami_CCRN, BSN, RN]

5 hours ago, MaxAttack said:

I've only used vecuronium once or twice. Rocuronium is the go-to for RSI and cisatracurium is the go-to for continuous infusions where I'm at. I'll handle one of these probably once a month or so.

My facility has the same policy; we only use vecuronium when our cisatracurium supply is low due to drug shortages. 

[JBMmom, MSN, NP]

18 hours ago, MaxAttack said:

Rocuronium is the go-to for RSI and cisatracurium is the go-to for continuous infusions where I'm at.

Same here. I'm not pulling a paralytic unless we're intubating a patient and anesthesia didn't bring it, or it's an intubated patient getting an infusion or single dose for vent compliance. Definitely NOT an every day med like versed. 

[RNperdiem, RN]

It is hard to answer this one. Before COVID, I last gave this maybe 19-20 years ago. When COVID ECMO patients came to our unit, I found myself using vecuronium now and then. 

It also depends on what kind of ICU. I have seen more use in the Medical ICU with high ventilator settings.

[Nursetom1963, BSN]

We use Rocuronium for intubation (up to the doc) and very rarely Vecuronium for some vented patients. I think they used to do it a lot more, even drips before I came to the ICU.  We used it alot more during Covid; and interestingly it seemed to help alot.  

[Mariel13]

Not a great answer but in my experience it really depends on the hospital and the ordering physicians. I’ve had a roc drip before for paralysis, in pediatrics vec is used for exacerbation of pulmonary hypertension I've heard people at other facilities say they use succinylcholine a lot more often. There are lots of paralytics to choose from and lots of opinions about which works best for what. I haven’t given them often, but most important thing is to always sedate before you paralyze and absolutely make sure you have an artificial airway of some type. 

[mmc51264, BSN, MSN, RN]

I think that question is more about how often a paralytic is used, in general. I am not an ICU nurse and know nothing about these meds other than they are used for intubation. 

I still am gobsmacked at why it was in an imaging area and able to be overridden. We don't override anything. If there is a life-threatening situation, I believe there are meds like that in our code carts. 

[Turtle in scrubs]

Agreed.  How often you give a paralytic is a better question. 

The drug was pulled from the Neuro floor and taken down to imaging, so, not pulled in imaging.  But still, not cool.  

Generally the only time I override meds is in semi-urgent situations.  Not crash cart urgent epi, and not like I have all day senna.  

Vanderbilt had just changed to a new computer system and overrides where pretty common to get even some basic stuff out.  Not an excuse, but no doubt it contributed.  

[2BS Nurse, BSN]

"There are lots of paralytics to choose from and lots of opinions about which works best for what. I haven’t given them often"

Are all of these new grads getting ANY training on paralytics???