A peripheral nerve stimulator, also called the “train of four”, is used to assess nerve function in patients receiving neuromuscular blocking agents (AKA paralytic medications). It is commonly seen used in critical care units. The main diagnosis that I have seen in my medical ICU for continuous paralytic use is with influenza patients in acute respiratory distress syndrome. These patients have literally no reserve and need to have their muscles as relaxed (or paralyzed) as possible to not push against the air being delivered by the breathing machine.

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