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Increased PACU Length of Stay – A Costly Matter

Postoperative residual curarization (PORC), also known as residual neuromuscular blockade, refers to the residual muscle paralysis that occurs after emergence from general anesthesia. PORC stems from the use of neuromuscular blocking agents (NMBAs). It is defined as a Train-of-Four (TOF) ratio of <0.9 and may occur in around 41% of patients who receive intermediate-acting neuromuscular blockers.1 PORC has been associated with critical respiratory events and impaired postoperative respiratory functions.2 It is also independently associated with an increased length of stay (LOS) in the post-anesthesia care unit (PACU). The increased PACU length of stay in turn impacts operating room throughput and results in prolonged waiting time for new PACU admissions.3

The Use of Quantitative NMT Monitoring to Avoid PORC

Subjective tests of NMT monitoring are not sensitive enough to detect residual weakness

Quantitative neuromuscular transmission (NMT) monitoring can help reduce the incidence of PORC. Neuromuscular monitoring is recommended when neuromuscular blockers have been administered as a part of general anesthesia. It can be carried out through subjective techniques, such as clinical assessment or peripheral nerve stimulation (qualitative monitoring), or with the help of objective or quantitative NMT monitors that provide a numeric value representing the depth of neuromuscular blockade. There is mounting evidence that clinical or subjective tests of NMT monitoring are not sensitive enough to detect residual weakness and do not predict adequate neuromuscular recovery. Quantitative or objective neuromuscular monitors should therefore be used whenever non-depolarizing NMBAs are administered.4,5,6

The Stimpod NMS 450X is a quantitative neuromuscular monitor that uses a 3D acceleromyography (AMG) transducer which is effective in detecting the full force of muscle contraction. It minimizes the risk of residual neuromuscular blockade and associated adverse respiratory events.7 As discussed below, this leads to a decrease in the average length of stay in the PACU and substantial cost savings for the hospital.

Reduction in the PACU Length of Stay as a Cost-reducing Measure

The economic structure of the PACU determines whether a cost-saving measure such as reducing the PACU length of stay is likely to reduce hospital costs. Hospital costs can be divided into fixed and variable components. Fixed costs are one-time costs that do not change in relation to the number of surgical cases. These include capital expenditures, such as gurneys, monitors, and the physical plant of the PACU. On the other hand, variable costs are directly related to the number of surgical cases, and include X-ray films, pharmaceuticals, dressings, and laundry.

The only real way of reducing PACU costs is to increase the productivity of the PACU and the staff

It is important to bear in mind that reducing the PACU length of stay will only affect variable costs. Small reductions in the length of time that patients stay in a PACU are unlikely to impact fixed costs at ambulatory surgery centers, which include the labor costs of staffing the PACU with full-time nurses.8 This means that reducing the length of stay of a patient in the PACU by one minute is not equivalent to saving one minute of PACU costs. Therefore, the only real way of reducing PACU costs is increasing the productivity of the PACU and the staff working in it.

Reduction in the Peak Number of Patients Improves Productivity and Reduces Costs

A reduction in the peak number of patients in the PACU is the most effective way to increase the productivity of the PACU and its staff. One way of doing this is to use anesthetic agents that permit a quicker discharge of patients from the PACU. However, if for example the average total time a patient stays in the PACU is 120 minutes, then for a modern anesthetic drug to reduce the peak number of PACU patients by 25%, the drug would have to reduce the mean time to discharge from a total of 120 minutes to just 34 minutes. Such a drastic change is unrealistic and therefore this method is limited in its effectiveness to achieve a substantial increase in PACU productivity.8

Optimization of the time of arrival of patients into the PACU is the single most important measure

For a PACU with salaried or full-time hourly employees, optimization of the time of arrival of patients into the PACU is the single most important measure that can reduce the peak number of patients in the PACU and decrease the peak requirements of nursing staff. This increases PACU productivity and results in PACU cost savings.8 According to a study conducted by Butterly et al., the mean length of stay in the PACU for patients with PORC was found to be 323 minutes whereas the length of stay for patients without PORC was 243 minutes.3 This shows that using the Stimpod NMT monitor for performing objective monitoring and avoiding residual neuromuscular blockade can save up to 80 minutes of the PACU time per patient. The Stimpod thus makes possible the “unrealistic” change that results in a significant reduction in peak patient numbers in the PACU.

Decrease in Operating Room Holding Time Results in Cost Reduction

Postoperative residual curarization results in delayed discharge of the patient from the PACU. If the PACU gets filled up with patients, the next patient has to wait before leaving the operating room resulting in operating room holds. The operating room/PACU system becomes congested. This has debilitating financial fallout as it increases the operating room costs. For instance, if all the operating rooms are filled up with patients waiting for PACU beds, some surgical cases may be delayed or cancelled. Also, in some situations, incentive salaries may have to be paid to the nurses and anesthetists for the extra time that they monitor patients in the operating rooms.3,9,10

The Stimpod quantitative NMT monitor provides an excellent solution to this problem—it minimizes the incidence of PORC and with it PORC-induced delay in PACU discharge. The increased availability of beds in the PACU allows for a quicker release of patients from the operating room. This cuts down operating room costs.

Stimpod NMS 450X—The Ultimate Cost-Saving Option

Stimpod NMS450X Neuromuscular Monitor

The Stimpod NMS450X Neuromuscular Monitor reduces the incidence of residual paralysis in 97% of patients

The Stimpod NMS 450X is a fully-automated neuromuscular monitor that supports Train-of-Four (TOF), Double Burst (DB), Post-Tetanic Count (PTC), Tetanus and Twitch Stimulation modes to perform accurate, real-time neuromuscular monitoring. It uses OneTouchTM technology that allows an entire case to be monitored—starting from automatic electrode placement to extubation—with the press of a single button. The Stimpod begins TOF monitoring and moves to PTC when a deep block is achieved. It detects the depth of neuromuscular blockade throughout the procedure and automatically reinitiates TOF monitoring when the patient begins the reversal process. The monitoring continues until the patient is more than 90% recovered.

The Stimpod NMS 450X is an all-in-one solution for quantitative NMT monitoring that can

  • minimize the incidence of PORC
  • reduce the length of stay in the PACU
  • increase the PACU productivity by decreasing the peak number of patients
  • decrease the operating room hold time

In short, it’s the perfect cost-saving measure for any PACU.

References

  1. Naguib M, Brull SJ, Johnson KB. Conceptual and technical insights into the basis of neuromuscular monitoring. Anaesthesia 2017; 72: 16–37.
  2. Boon M, Martini C, Dahan A. Recent advances in neuromuscular block during anesthesia. F1000Res. 2018;7:167. Published 2018 Feb 9. doi:10.12688/f1000research.13169.1
  3. Butterly A, Bittner EA, George E, Sandberg WS, Eikermann M, Schmidt U. Postoperative residual curarization from intermediate-acting neuromuscular blocking agents delays recovery room discharge. Br J Anaesth 2010; 105: 304–9.
  4. Duţu M, Ivaşcu R, Tudorache O, et al. Neuromuscular monitoring: an update. Rom J Anaesth Intensive Care. 2018;25(1):55–60. doi:10.21454/rjaic.7518.251.nrm
  5. Abdulatif M. Neuromuscular transmission monitoring: Beyond the electric shocks and the shaking hands. Saudi J Anaesth. 2013;7(2):115–117. doi:10.4103/1658-354X.114045
  6. Naguib M, Brull SJ, Kopman AF, et al. Consensus statement on perioperative use of neuromuscular monitoring. Anesth Analg 2018; 127: 71–80.
  7. Murphy GS, Szokol JW, Marymont JH, Greenberg SB, Avram MJ, Vender JS, Nisman M. Intraoperative acceleromyographic monitoring reduces the risk of residual neuromuscular blockade and adverse respiratory events in the postanesthesia care unit. Anesthesiology 2008;109:389–98.
  8. Macario A., D. Glenn and F. Dexter, 1999, What can the postanesthesia care unit manager do to decrease costs in the postanesthesia care unit?, J Perianesth, vol 14, pp. 248-93.
  9. McLaren JM, Reynolds JA, Cox MM, et al. Decreasing the length of stay in phase I postanesthesia care unit: an evidence-based approach. J Perianesth Nurs. 2015;30:116-123.
  10. Cammu G. Sugammadex: Appropriate Use in the Context of Budgetary Constraints. Curr Anesthesiol Rep. 2018;8(2):178–185. doi:10.1007/s40140-018-0265-6
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Anesthesia Hygiene – Infectious Control

Anesthesia Machine Covers Prevent Infections!


Guidance issued by Society for Healthcare Epidemiology of America (SHEA): “…explore the use of disposable covers”

Anesthesia Hygiene machine covers have tear away pouches that hold and contain contaminated supplies such as laryngoscopes and yankauer suction! The use of disposable covers is endorsed by SHEA and ASPF.

Anesthesia Hygiene Covers protect your patient and your anesthesia machine from pathogens and infectious diseases. To view videos and more information on our webpage Anesthesia Hygiene Covers and anesthesiahygiene.com .

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POM Mask – Don’t just detect Hypoxia, Prevent it.

“The Procedural Oxygen Mask achieves the triple goal of the following: 1) providing reliable FiO2 delivery of 0.90 to 0.95 at O2 flow rates of 10 to 15 L/min, 2) allowing easy access to the nose and mouth via the self-sealing endoscopy ports, and 3) providing a continuous capnography sampling port.”

René Miguel Gonzalez, MD, Department of Anesthesiology, Hackensack Meridian Health Southern Ocean Medical Center, Stafford Township, N.J.


Full Article Link Here

 Benefits of The POM Procedural Sedation Mask:
 • Dual oral and nasal entry ports for endoscopes
 • Improves O2 concentration during conscious sedation up to 92%FiO2
 • Measures capnography reliably even at high oxygen flows
 • Allows easy unobstructed access to the patient
 • Ideal for Oral or Nasal fiber optic intubations

Enhanced Patient Safety: The POM provides accurate capnography readings allowing clinicians to intervene proactively, while providing over twice the FiO2 of standard O2/CO2 nasal cannulas.  POM reduces the risk of hypoxia during gastrointestinal endoscopy procedures.  Now available with Oridion MicroStream capnography sample lines. 

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AANA 2019 Annual Congress

Nasoral - Murphy - Cuffed

Bell Medical will feature six new and innovative products at the AANA 2019 Annual Congress in Chicago. Come see us at Booth 710 for FREE label samples, a demonstration, or a trial.


EyePro

The EyePro is a sterile dressing that keeps the eyelid closed during procedures.


NoPress

The NoPress is a mask shield that protects the eyes.


BiteMe

BiteMe tooth protectors.


Total Control Introducer

Total Control Introducer takes the “difficult” out of “difficult airways”.


Stimpod 450X Quantitative TOF Monitor

The Stimpod 450X is a quantitive Train-of-Four monitor that requires no calibration.


Click-To-Comply Syringe Labeling System

Two-Clicks, Two Seconds. The Vigilant Labeling System is USP 797 compliant.

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Bell Medical 2018 Anesthesia Meetings Schedule

Rubber Flex Connector

Bell Medical’s mission is to introduce innovative technology to anesthesia providers in hospitals and surgery centers.  We show our commitment to this mission by supporting anesthesia societies such as the American Association of Anesthesiologist or ASA, the American Association of Nurse Anesthetist or AANA and the American Society of Technicians and Technologists or the ASATT.  We also attend numerous state anesthesia meetings for both MDs and CRNAs.  We invest over $50,000 annually to attend both national, regional and state association meetings.  The listing below is some of the anesthesia meetings we attend to exhibit our innovative technologies.  Please visit our booth!

ASATT at Bally’s Las Vegas, NV August 23-25
AANA in Boston, MA September 23-25
MOANA in St. Louis, MO October 19-21
WANA in Spokane, WA October 7-9
VANA in Norfolk, VA October 13
ASA in San Francisco, CA October 13-15
FANA in Tampa, FL October 19-21
EMS Worldwide in Nashville, FL October 31-November 2
NCANA in Cherokee, NC November 2-4
PGA in New York City, NY December 8-10

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Stimpod NMS460 by Xavant Receives FDA Approval

PRETORIA, South Africa, Aug. 1, 2017 /PRNewswire/ — Xavant Technology (Pty) Ltd today announced that the U.S. Food and Drug Administration (FDA) cleared their Stimpod NMS460. With the U.S. patent awarded on proprietary hybrid pulsed radio frequency (PRF) waveform, this non-invasive neuromodulation device is focused on the symptomatic relief and management of chronic intractable pain, as well as an adjunctive treatment in the management of post-surgical pain, post-traumatic acute pain problems, and an adjunct for pain control due to rehabilitation.

The need for this device is profound. More than 100 million Americans report that they have a problem with pain.[1] Chronic pain is characterized by neuroplastic changes that cause sensitization of the nervous system. These changes result in anatomical and physiological changes that affect neurological function, which causes long-term potentiation and gene expression changes that then allow the pain to continue with or without further peripheral input, and a lower pain threshold; this dysfunction then also accounts for the epiphenomena associated with the disease, including emotional, memory, and motor changes, which then becomes the illness of chronic pain.[2]

Treatment of chronic pain in the United States is estimated to cost $600 billion annually.[3] The current standard of care for chronic pain includes drug cocktails such as Corticosteroids, Opiate pain relievers, injections, and beyond combined with treatments like physical therapy and counseling. Treatments can come with various short-term and long-term side effects.

The Stimpod NMS460, however, will greatly impact the industry as a non-invasive, non-drug solution with zero side effects and a fast onset of effect at a fraction of the cost of comparable treatments. The device applies its patented PRF waveform to the affected area transcutaneously. This waveform creates electromagnetic effects similar to invasive pulsed radio frequency treatments, and several case studies have shown instant and dramatic relief of chronic intractable pain. The Stimpod NMS460 also incorporates the nerve-locating technology which features a nerve mapping probe that enables practitioners to locate nerves and evaluate the treatment progress of damaged nerves. Bell Medical has been selected as the master distributor for both the U.S. and Canada.

“We are thrilled at the news that our revolutionary device can now be used in the U.S.,” said Corlius Birkill, CEO of Xavant Technology (Pty) Ltd. “This groundbreaking technology has the ability to help tens if not hundreds of millions of people just in the U.S. as a valuable treatment asset for neurologists, chiropractors, acupuncturists, physical therapists, physiatrists, and medical pain practitioners.”

About Xavant Technology (Pty) Ltd
Xavant Technology (Pty) Ltd is a leading supplier of nerve stimulators for regional and general anesthesia applications. The current Stimpod range has three models – the NMS410, NMS450 and NMS460. The Stimpod NMS460 is a neuromodulation device used for symptomatic relief of chronic intractable pain, implementing a unique patented Pulsed Radio Frequency waveform for the treatment of neuropathies. The Stimpod NMS410 model is a specialized nerve locating device, with its unique nerve mapping and locating cable, used primarily during Regional Anesthesia procedures. The Stimpod NMS450 adds the option to monitor neuromuscular blocking agents with its advanced three-dimensional accelerometer. Learn More About STIMPODNMS460 at http://www.stimpodnms460.com.

Media Contact:
Lourie Höll
Phone: +27 12 743 5959
Email: [email protected]

[1] Gaskin, Darrell J., and Patrick Richard. “The Economic Costs of Pain in the United States.” The Journal of Pain: Official Journal of the American Pain Society (2012): 715-24. Web. 21 June 2017.

[2] American Academy Of Pain Medicine. Neuropathic Pain Recognized as a Disease. N.p.: American Medical Association, 27 Sept. 2016. PDF. https://assets.ama-assn.org/sub/meeting/documents/i16-resolution-912.pdf

[3] Gaskin, Darrell J., and Patrick Richard. “The Economic Costs of Pain in the United States.” The Journal of Pain: Official Journal of the American Pain Society (2012): 715-24. Web. 21 June 2017.

Source: PR Newswire

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Amsorb Plus Review

When choosing a type of CO2 absorbent, it is important to understand the absorbents environmental impact, effect on patient safety, ease of use and the effect on the consumption of volatile anesthetics. Today we are going to review Amsorb vs. soda limes that contain traces of Sodium Hydroxide, NaOH, such as Medisorb, Sodasorb, Dragersorb and others.

Environmental Impact

Soda limes can have a pH of up to 14 and may require disposal as a hazardous waste according to U.S. Federal Code of Regulations. Soda limes contain sodium hydroxide and are considered corrosive.

Amsorb Plus has a pH of less than 12.5 and is safe for our water table and landfills where it will break down into harmless organic compounds. Amsorb Plus comes with certification of such (see Amsorb Plus disposal document). Kaiser Permanente independently tested all the types of CO2 absorbents readily available on the market and determined Amsorb Plus to be the only one that was safe for disposal in regular landfills. Other types of CO2 absorbents had higher pH and needed to be red bagged and incinerated at greater expense. Amsorb Plus is not harmful in disposal to the environment which translates into a cost savings for hospitals and surgery centers since red bagging is expensive and time consuming.

Patient Safety

Soda limes are known to degrade volatile anesthetics to Carbon Monoxide, Compounds A – F, and Formaldehyde.

Amsorb Plus has no strong alkali and is incapable of producing any of these toxins. Clinical Anesthesia by Barash, 2012, recommends using Amsorb Plus by name and states doing so: (Amsorb Plus)

eliminates all of the potential complications related to anesthetic breakdown and therefore minimizes the possibility of additional costs from those complications, including additional laboratory tests, hospital days, and medical/legal expenses. Adoption of [Amsorb Plus] into routine clinical practice is consistent with the patient safety goals of our anesthesia society.

Ease of Use & Consumption of Volatile Anesthetic

Soda Lime users generally change absorbent based on color change and never know for sure when to change product. Users usually error on the side of caution and change soda lime more often (a wasteful and confusing practice) because if they don’t change soda lime it is possible to endanger the patient by producing toxins such as Compound A, Formaldehyde and Carbon Monoxide. Soda Lime includes a dye that changes color to indicate exhaustion. However, it does not retain color change for long before reverting back to looking fresh. The user can never be sure when product should be changed. Ask any clinician that has used a soda lime and they will verify it is not uncommon to begin a case with what they think is fresh absorbent only to immediately find out they have high levels of FiCO2 and rapid color change of their absorbent.

Soda Limes “adsorbs” (significant amounts of volatile anesthetic which means clinicians wait longer periods of time for their machines and vaporizers to equilibriate. They are less able to reach desired drug percentages without increasing vaporizer settings.

Amsorb Plus has permanent, consistent, and reliable color change. Thus allowing the user to easily tell the state of the absorbent at a glance. Amsorb Plus also adsorbs far less anesthetic vapor than soda limes so machines and vaporizers reach equilibriation faster and accurately reach desired drug percentages without needing to increase vaporizer settings above what is desired for patient inspiration. This saves time and money (utilizing less anesthetic vapor).

Amsorb vs. Soda Lime Review Summary

Soda Lime Amsorb Plus
Environmental Impact
Patient Safety
Ease of Use & Consumption of Volatile Anesthetic

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Neuromuscular Blocking Agent Monitoring with Stimpod NMS 450 Quantitative TOF Monitor

A presentation to the ASATT or American Society of Anesthesia Technicians and Technologists at the 2016 ASATT meeting in Chicago, IL was delivered by Kevin Lueders of Bell Medical and Corlius Birkill of Xavant Technologies of South Africa. This power point presentation discusses neuromuscular blocking agents history and usage. It also presented the various methods of monitoring NMBAs with traditional peripheral nerve stimulators and with the new quantitative or objective Train of Four, TOF monitor such as the Stimpod NMS 450 using accelerometry.

[slideshare id=68006063&doc=asatt2016bellnmbapresentation2-161101185645]

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Alar Nasal Pulse Oximetry Sensor: Anesthesia Application

Ventilator Circuit, Disposable, Latex-Free

Alar Nasal Pulse Oximetry Sensor works on the most challenging patients!

Anesthesia Advantages

“It works when other sensors fail.” The monitoring site is unaffected by non-invasive blood pressure measurements thus reducing false alarms and giving the anesthesia provider uninterrupted oximeter measurements. The Alar Nasal Pulse Oximetry Sensor can be left on for PACU and SICU providing oximeter measurements for the entire length of stay of the post-surgical patient saving the hospital thousands and enhancing patient comfort.

Reliable accuracy – unaffected by poor peripheral perfusion or low saturations

The Alar Nasal Pulse Oximetry Sensor fits comfortably on the fleshy part of the side of the nose. The site is fed by both the external and internal carotid arteries; the latter also provides blood to the brain. The rich vascular supply to this region provides a strong, reliable signal, even when it is difficult or impossible to get a signal at the fingertips.

Monitoring Site results in faster detection of oxygen saturation changes

Because the Alar Nasal Pulse Oximetry Sensor measures the oxygen saturation from a vessel also supplying blood to the brain, changes have been proven to be detected up to 30 seconds faster than with a finger sensor.

Improved patient comfort

The hands-free Alar Sensor does not impede normal patient functions such as eating, drinking or talking. It is less bothersome and is not likely to become disconnected.

Cost effective and convenient

The single-patient-use Alar Sensor does not use adhesives at the sensor site. The sensor can be removed and reapplied for up to 7 days saving hospitals up to $232 for the SICU patient. Proven accuracy reduces false alarms improving patient safety, patient satisfaction and nurse productivity.

Call 800-875-BELL(2355) for More Information.

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TOF Watch Discontinued! Stimpod NMS 450 available NOW!

The German manufacturer, MIPM – Mammendorfer Institut für Physik und Medizin GmbH has announced that effective June 30, 2016 the TOF Watch, TOF Watch S and TOF Watch SX neuromuscular monitors will no longer be manufactured.  The official announcement of the discontinuance of the TOF Watch is below:

TOF-Watch – objective neuromuscular monitoring
Product cancelation Note
We wish to inform you that the TOF Watch monitors are not produced and sold any more effective July 1st 2016.

Their USA distributor Blue Star Enterprises will continue selling the TOF Watch while supplies last. They will also offer the replacement alternative from Bell Medical and Xavant called the Stimpod NMS 450. The only accelerometer based neuromuscular monitor now available is the Stimpod NMS 450 from Xavant distributed in the USA and Canada by Bell Medical Inc. The Stimpod NMS 450 is a neuromuscular monitor that offers Quantitative TOF Monitoring as endorsed by the Anesthesia Patient Safety Foundation or APSF.

Stimpod NMS 450 Nerve Stimulator and TOF Monitor

Stimpod NMS 450The Stimpod NMS 450 Nerve Stimulator and TOF Monitor includes a Tri-axial accelerometer which provides real time feedback of the strength of contraction of the affected limb (Train Of Four, Double Burst and Post Tetanic Count modes). The strength of each measured contraction is displayed graphically and the relevant ratios are calculated and also displayed.

The fine movement differences that can be detected by utilizing accelerometry offer major advantages over gauging contraction strength visually or tactilely.

Tri-axial accelerometry calculates the movement vector of the contraction in three dimensions. This negates the need for calibration as is the case with one-dimensional accelerometers, and reduces the setup time of the procedure.

Combined Nerve Mapping and Nerve Location

Auto sensing technology provides a solution for simultaneous nerve mapping and nerve location. The Stimpod monitors whether the mapping probe or needle touches the patient and adjusts the current range accordingly, ensuring quick and precise nerve location.

The Stimpod Nerve Mapping Probe was designed to enable transcutaneous nerve mapping at higher currents (to a maximum of 20mA), whilst the tip offers a contact surface small enough to ensure effective discrimination.

Current Range Load Impedance Stimulating Modes
Nerve Locating: 0.0 – 5.0mA
Nerve Mapping: 0 – 20mA
NMBA Monitoring: 0 – 80mA
Nerve Locating: 0 – 20kΩ (100V)
Nerve Mapping: 0 – 20kΩ (400V)
NMBA Monitoring: 0 -5kΩ (400V)
Train-of-Four (TOF)
Double Burst (DB)
Post-Tetanic-Count (PTC)
Tetanus (TET)
Twitch (1Hz, 2Hz, 5Hz)

Kit includes:

  • STIMPOD NMS450
  • NMBA Monitoring Cable
  • Nerve Locating Cable
  • Nerve Mapping/Locating Cable
  • Carrying Case

Stimpod NMS 450 Comparison Study

TOF Watch (discontinued) STIMPOD NMS450
NMBA Monitoring (Objective) Yes – 1 Dimensional Accelerometer Yes – 3 Dimensional Accelerometer, enhanced accuracy
Calibration Before TOF Monitoring Yes No, easier setup and operation
Nerve Mapping No Yes – Integrated StimPen results in superior nerve blocks
Nerve Block Application Yes Yes
Pulse Width Selections 0.04ms, 0.2ms 0.05ms, 0.1ms, 0.3ms, 0.5ms, 1ms
Current Range Nerve Locating 0.0 – 6.0 mA
Nerve Mapping None
NMBA Monitoring 0 – 60 mA
Nerve Locating 0.0 – 5.0 mA
Nerve Mapping 0 – 20 mA
NMBA Monitoring 0 – 80 mA
Adjustable Timers Yes Yes
Auto Sensing Technology Yes Yes – Combination Cable Auto Sensing
Warranty Limited One Year Warranty Two Year Warranty
TOF Bar Graph Display No Yes
Lead Wire Construction 18 Gauge OD, thin and fragile 12 Gauge OD, thick and heavy duty, easy thumb application, 6 month cable warranty
Lead Wire & Accelerometer Cable Replacement Cost $296 $260, 12% savings
Device Attachment IV Pole Attachment Drape clip or IV pole option