Paralytic and Sedation

[Tabitha871]

Generally how long are you waiting to turn down sedation after an IV paralytic had been discontinued and turned off? Specifically Nimbex and Roc?

I'm travel nursing during the pandemic and have ran into a bunch of issues with this. So I’m trying to get some opinions. 

[JBMmom, MSN, NP]

We don't have enough train-of-four set ups for more than 2 patients at a time, and we haven't got BIS monitors yet. We have been titrating paralytics and sedation based on ventilator synchrony for many of our COVID patients. Fortunately, our use of paralytics has decreased greatly recently and we are able to manage many of our patients, even proned, with sedation only and no paralytics. I have had a few coworkers reference decreasing sedation while on paralytics so we have had to re-educate on the necessity of sedation for paralyzed patients. Glad you're looking into this to make the best treatment decisions for your patients.