Phase 1, Depolarizing agents act as: agonist or antagonist?? - CORRECT ANSWER -
Agonist then antagonist
Train of Four Ratio - CORRECT ANSWER - Strength of 4th twitch:Strength of 1st twitch
(when it is 90% patient considered recovered)
Best nerve/muscle to measure onset of NMB - CORRECT ANSWER - Facial Nerve
Orbicularis Oculi (Corrugator supercilii = best)
(reflects diaphragm blockade)
(negative-black electrode over nerve)
Best nerve/muscle to measure emergence from NMB - CORRECT ANSWER - Ulnar
Nerve
Adductor Pollicis
Measures thumb adduction (Red proximal)
,Single Twitch Test - CORRECT ANSWER - 1.0 Hz
Single stimulus
Compares pre (baseline) and post NMB hand twitch
Train of Four Test - CORRECT ANSWER - 4 - 2 Hz twitches
Compares 4th twitch to 1st twitch (fade)
Reflects 70-100% blockade
*Succ has no fade, all 4 twitches equal*
Double Burst Simulation (DBS) Test - CORRECT ANSWER - 2 - 50 Hz twitches
0.75 seconds apart
Compares 2 twitches to monitor for fade
Tetanus Test - CORRECT ANSWER - 100 Hz twitch for 5 seconds
Painful
Posttetanic Count Test - CORRECT ANSWER - 50 Hz stimulus for 5 sec → 3 sec pause
→ 1 Hz single twitch every second
Only used when patient is 100% paralyzed
0 = call for ventilator (>9 minutes til TOF)
4 = 4 minutes until TOF possible
8= 0-2 minutes until TOF
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