Avoiding Respiratory Complications Checklist

Train of Four monitor in every operating room (acceleromyography,

peripheral nerve stimulators)

Replacement batteries for monitor easily accessible

Tidal volume for ideal body weight reference cards available on each

anesthesia cart and online

Change default ventilator settings to:

 400-500 cc tidal volume

 Rate 10-12

 PEEP ~5

Build Ideal Body Weight Calculations into electronic health record

Consider real-time alerting options for TV>10cc/kg, NMB reversal,

Train of Four monitoring, and recruitment maneuver reminders if

available

Check ASPIRE dashboard on monthly basis for performance review.

Target low performers with highest volume first for education

Utilize ARC Toolkit Presentation to promote best practice

Present performance review at departmental QI meetings