NEUROMUSCULAR MONITORING BY INTENSIVE-CARE NURSES - COMPARISON OF ACCELEROMYOGRAPHY AND TACTILE ASSESSMENT

We have compared tactile assessment of the train-of-four (TOF) count a nd TOF ratio by nursing staff, with measurements made by a new acceler omyographic monitor, the TOF-Watch. We assessed neuromuscular block in 30 sedated intensive care patients receiving a continuous infusion of atracurium. Five nurses made a tactile assessment of neuromuscular bl ock in each patient within a 5-min period. Each assessment was paired with a blinded TOF-Watch measurement. The nurses were accurate in asse ssing twitch count in 55% of measurements and they tended to overestim ate the degree of block using tactile assessment of TOF ratio.