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Source:

Nursing2015

January 2006, Volume 36 Number 1 , p 14 - 14

Author

  • MICHAEL R. COHEN RPH, MS, ScD

Abstract

Vials of the neuromuscular blocking agent pancuronium were misplaced in a bin holding vials of heparin flush solution. A nurse failed to notice the switch and flushed a patient's central venous catheter with pancuronium, which caused respiratory and cardiac arrest. The patient recovered after 10 hours of mechanical ventilation...

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