Online Courses

The Use of Neuromuscular Monitoring During Standard Induction of Anesthesia

Price: $25.00
Nursing CE: 1.50
This course is accessible until 9/1/2027

Reviewed literature has shown that a train-of-four (TOF) of 0/4 before tracheal intubation improved intubating conditions and reduced the incidence of vocal cord damage. Current literature demonstrates that the standard dosing of rocuronium may be insufficient to provide adequate neuromuscular blockade (NMB) for intubation. Operative conditions, blood loss, narcotic requirements, and retractor pressures were all reduced with sufficiently deep neuromuscular blockade.  Use of periferal nerve stimulation (PNS) decreases the amount of reversal agent administered, which is both a cost saving and an improvement in patient safety outcomes. Additionally, clinical subjective assessments frequently fail to detect residual neuromuscular blockade, a condition associated with increased morbidity, length of stay, and cost of care. Objective monitoring is the most effective tool to help providers ensure complete reversal of NMB and return of muscle strength. Assurance of full reversal decreases the incidence of residual paralysis and its associated complications and costs. 

 

Upon successful completion of this course, the participant will be able to:

  • Discuss the physiology of the NMJ and how it is affected by NMB agents. 
  • Demonstrate proper application and placement of a PNS.
  • Compare and contrast subjective vs. objective assessments of NMB. 
  • Discuss improvements in patient safety outcomes associated with use of a PNS. 
  • Identify and discuss the implications of residual NMB and inadequate NMB in surgical patients. 

Qualified Planners/Faculty

Tanisia Esalomi, BSN, RN

Tanisia Esalomi is a graduate student in the Doctorate of Nurse Anesthesia Program at AdventHealth University. Tanisia graduated from the University of Florida where she received her Bachelor of Science in Nursing degree. While at the University of Florida, she became a McNair Scholar where she was introduced to research and achieved her first publication as a coauthor. After being employed as a medical-surgical intensive care nurse for two years she then worked as a critical care travel nurse for six months during the COVID-19 Pandemic. Tanisia was born and raised in Tampa, Florida, and comes from a family of nurses which sparked her love for the field. Outside of life as a student and registered nurse, Tanisia enjoys traveling and spending time with family and friends. 

Disclosures

The content of this activity was not developed with support from any commercial companies nor are there any staff commercial affiliations.

This author has disclosed no relevant financial relationships associated with this activity.

Morgan Lyles, BSN, RN

Morgan Lyles is a graduate student in the Doctorate of Nurse Anesthesia Program at AdventHealth University. Morgan graduated with her Bachelor of Science in Nursing in 2019 from Jacksonville State University. Prior to the DNAP program, Morgan worked as a cardiovascular intensive care nurse for two years at Erlanger Hospital in Chattanooga, Tennessee. Morgan specialized in open heart surgery recovery and cardiac assist devices. She was involved in leadership in her unit and was chosen as an Emerging Leader in 2020 through Erlanger Hospital. Outside of healthcare, Morgan is passionate about family, faith, the outdoors, and her dog, Remi. Morgan is an avid learner and is eager to improve patient outcomes involving anesthesia.

Disclosures

The content of this activity was not developed with support from any commercial companies nor are there any staff commercial affiliations.

This author has disclosed no relevant financial relationships associated with this activity.

Lauren Prochnow, BSN, RN-C, EFM

Lauren Prochnow is a graduate student in the Doctorate of Nurse Anesthesia Program at AdventHealth University. Lauren began her professional career in healthcare as an EMT-Paramedic before graduating from Chamberlain College of Nursing in 2014 with her BSN. Her journey through the medical field has brought her experience in emergency medicine, obstetrics, critical care, and nursing leadership, and has ultimately led her to AdventHealth University. She is a member of the American Association of Nurse Anesthesiology, the American Association of Critical Care Nurses, and the Association of Women’s Health, Obstetric, and Neonatal Nurses. Her professional certifications include inpatient obstetrics and electronic fetal monitoring. She and her husband are proud fur-parents to a little bully mix named Reva. She loves anything involving food, the beach, or dogs. Some of her favorite hobbies include fishing, reading, and tending to her saltwater aquarium. 

Disclosures

The content of this activity was not developed with support from any commercial companies nor are there any staff commercial affiliations.

This author has disclosed no relevant financial relationships associated with this activity.

Brittany Workman, BSN, RN

Brittany Workman is a graduate student in the Doctorate of Nurse Anesthesia Program at AdventHealth University. A native of Central Florida, Brittany is born at AdventHealth Altamonte and has lived in Orlando area her entire life. She started working in healthcare as a nursing assistant. After graduating with her BSN, she went on to work with advanced heart failure patients in the cardiac/medical ICU at AdventHealth Orlando. She thoroughly enjoyed her time in the ICU and knew she wanted to expand her career into a field of advanced practice nursing that allowed her to not only develop the specific skills she had learned but further understand and apply them. While the DNAP program has proven challenging, Brittany feels that she has learned a great deal and continues to do so as she grows through this program to become a CRNA. Brittany and her husband met in nursing school at AdventHealth University and are currently expecting their first baby! Aside from school, she enjoys going to the beach, traveling, and taking her dog swimming. 

Disclosures

The content of this activity was not developed with support from any commercial companies nor are there any staff commercial affiliations.

This author has disclosed no relevant financial relationships associated with this activity.

Brooklyn Wurl, BSN, RN, CCRN

Brooklyn Wurl is a graduate student in the Doctorate of Nurse Anesthesia Program at

AdventHealth University. Brooklyn graduated from Southern Adventist University in 2019 with a BSN and started her career working in the medical intensive care unit at Erlanger Hospital in her hometown of Chattanooga, TN. Brooklyn is a member of the American Association of Nurse Anesthesiology and has professional certification as a Critical Care Registered Nurse from the American Association of Critical Care Nurses. Aside from work and school, she loves baking desserts, taking pictures, hosting events, exploring Florida’s beaches and springs, and spending time with her husband and dog. 

Disclosures

The content of this activity was not developed with support from any commercial companies nor are there any staff commercial affiliations.

This author has disclosed no relevant financial relationships associated with this activity.

- 8/31/2027
Suite 400
8515 Georgia Avenue
Silver Spring, Maryland 20910-3492
Phone: 800-284-2378
https://www.nursingworld.org
Contact Hours: 1.50, Category: B: (Advanced Beginner)/Progressive Care: Anesthesiology
- 8/31/2027
1123 South University Ave
# 800
Little Rock, AR 72204
Phone: 501-686-2700
https://www.arsbn.org/
CE Credits: 1.50, Category: General

Registered Nurse
Registered Nurse Practitioner
Certified Nurse Practitioner
Clinical Nurse Specialist
Licensed Practical Nurse
Licensed Psychiatric Technician Nurse
Certified Registered Nurse Anesthetist
Certified Nurse Midwife

- 8/31/2027
899 North Capitol Street, NE
Washington, DC 20002
Phone: 877-672-2174
https://dchealth.dc.gov/bon
Contact Hours: 1.50, Category: General

Registered Nurse (Clinical Nurse Midwife)
Registered Nurse (Clinical Nurse Specialist)
Licensed Practical Nurse
Registered Nurse (Nurse Practitioner)
Registered Nurse
Registered Nurse (Registered Nurse Anesthetist)

- 8/31/2027
4052 Bald Cypress Way
BIN C-02
Tallahassee, Florida 32399-3252
Phone: 850-245-4444
https://floridasnursing.gov/
Contact Hours: 1.50, Category: General

Registered Nurse
Advanced Practice Registered Nurse
Licensed Practical Nurse
Certified Nursing Assistants

- 8/31/2027
CE Credits: 1.50, Category: General
- 8/31/2027
237 Coliseum Drive
Macon, GA 321217
Phone: 478-207-2440
https://sos.ga.gov/georgia-board-nursing
Continuing Education Hours: 1.50, Category: General

Licensed Practical Nurse
Registered Professional Nurse

- 8/31/2027
312 Whittington Pkwy
# 300
Louisville, KY 40222
Phone: 5024293300
https://kbn.ky.gov
CE Credits: 1.50, Category: General

Licensed Practical Nurse

Registered Nurse

- 8/31/2027
900 SW Jackson
Landon State Office Building, Suite 1051
Topeka, KS 66612
Phone: 785-296-4929
https://ksbn.kansas.gov/
CE Credits: 1.50, Category: General

Registered Nurse

Licensed Practical Nurse

Nurse Practitioner

Clinical Nurse Specialist

Nurse Midwife

Registered Nurse Anesthetist

- 8/31/2027
Bureau of Professional Licensing
611 W. Ottawa
Lansing, MI 48933
Phone: 517-241-0199
https://www.michigan.gov/lara/bureau-list/bpl/health/hp-lic-health-prof/nursing
Contact Hours: 1.50, Category: General

Registered Nurse

Licensed Practical Nurse

Registered Nurse Special Volunteer

Licensed Practical Nurse Special Volunteer

- 8/31/2027
713 S. Pear Orchard Road
Suite 300
Ridgeland, MS 39157
Phone: 601-957-6300
https://www.msbn.ms.gov/
Contact Hours: 1.50, Category: General

Registered Nurse

Licensed Practical Nurse

- 8/31/2027
919 S. 7th Street
Suite 504
Bismarck, ND 58504
Phone: 701-328-9777
https://www.ndbon.org
Contact Hours: 1.50, Category: General

Advanced Practice Registered Nurse
Licensed Practical Nurse
Registered Nurse

- 8/31/2027
6301 Indian School Rd NE
Suite 710
Albuquerque, New Mexico 87110
Phone: 5058418340
https://nmbon.sks.com
Contact Hours: 1.50, Category: General

Registered Nurse
Licensed Practical Nurse
Certified Registered Nurse Anesthetist
Certified Nurse Practitioner
Clinical Nurse Specialist

- 8/31/2027
121 S Fruit St
Concord, NH 03301
Phone: 603-271-2152
https://www.oplc.nh.gov/new-hampshire-board-nursing
Contact Hours: 1.50, Category: General

Registered Nurse (RN) 

Advanced Practice Registered Nurse (APRN)

Licensed Practical Nurse (LPN)

- 8/31/2027
110 Centerview Drive
Columbia, South Carolina 29210
Phone: 803-896-4550
https://llr.sc.gov/
Contact Hours: 1.50, Category: General

Advanced Practice Registered Nurse
Licensed Practical Nurse
Registered Nurse

- 8/31/2027
671 Winyah Drive
Orlando, Florida 32803
Phone: 4073039798
https://www.ahu.edu/academics/doctor-of-nurse-anesthesia-practice
Class A CE Credits: 1.50, Category: Neurological & Neuromuscular Systems
- 8/31/2027
130 Hobbs Ave
Suite B
Cheyenne, WY 82002
Phone: (307)777-7601
https://wsbn.wyo.gov/
CE Credits: 1.50, Category: General

Certified Nurse Midwife
Certified Nurse Practitioner
Certified Nurse Specialist
Certified Nursing Assistant
Certified Registered Nurse Anesthetist
Licensed Practical Nurse
Registered Nurse

- 8/31/2027
90 MacCorkle Ave. SW
Suite 203
South Charleston, WV 25303
Phone: 304-744-0900
https://wvrnboard.wv.gov/
Contact Hours: 1.50, Category: General

Registered Nurse
Advanced Practice Registered Nurse

There have been no relevant financial relationships disclosed by planners, authors, or presenters; nor has there been disclosures of any relevant financial relationships with any healthcare related proprietary entity with goods or services relevant to this activity.

Completion Requirements: To receive continuing education credit commensurate with the credit awarded for this on-line activity, the participant must:

  • View all modules.
  • Participate and pass all learning/self-checks.
  • Pass the Post Test with a minimum score of 80%, you will be allowed up to 3 retakes but be aware the post test questions will change with each re-take.
  • Complete and submit the on-line evaluation/survey.

Certificates of Completion: will be available to print immediately upon finishing the completion requirements. You are encouraged to print and save your certificate for your portfolio as required by your licensing body. Interdisciplinary accredited activities, activities having multiple accreditors, will be listed individually on the Certificate of Completion.

Electronic Record Retention: All activity records are kept on file for a minimum of six (6) years.

System Requirements:

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Browser

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Chrome/Safari/Edge/Firefox

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Mobile Devices

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Internet Connection

For stable video playback in our courses, we recommend your internet connection provide bandwidth of 5 Mbps or faster. The videos in our courses are designed for HD (high definition) playback, but if your internet connection is slow, video resolution may automatically be reduced to a lower resolution in order to continue uninterrupted streaming of the video. Inadequate internet connection speeds may also result in pausing of video playback.

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The videos in our courses do have sound, so your device will need to support sound with speakers or headphones. Please note that due to the vast number of different hardware configurations available in desktop, laptop, tablet and mobile phone devices, we are unable to provide specifications for minimum hardware requirements.