train of four

[rarjn5]

can anyone direct me to protocols on train of four? Or does anyone know about the parameters for train of four and guidelines on how to administer the test. And is it mainly used for a drip for a paralytic rather than a particular procedure/event?

[HillaryC, RN, CRNA]

Thank you for the information. Does anyone know why steroids are contraindicated with paralytics? How do steroids and paralytics interact to cause a adverse reaction? I really appreciate all this information. It is very helpful.

I just learned this yesterday from a coworker. She said there is a risk of peripheral demyelination when paralytics and steroids are used together.

[rarjn5]

Oh good, somebody who has heard of the adverse effects of paralytics and steroids used together. I my short time in critical care I have not seen a paralytic drip. What I have seen in my small Unit is the use of norcuron as a prn, used in specific situations. That same pt my also be on IV steroids. I wondered if the IV steroid should be spaced so as not to be given close to the paralytic? My other question is have you ever heard of using Train of Four for prn doses of paralytic, which by the way can be given frequently.