TITLE: Cascade Train of Four Quick Setup P/N: N/A

AUTHOR: Elizabeth Huber

DATE: 9/18/14

PAGE 1

Train of Four

Cascade train of four mode setup instructions are found in the Cascade help file. This document is intended as adjunct information. The Train of Four option must be checked in system setup.

Screen Shots of successful Train of Four:

(Median Nerve to APB Train of Four)

(Tibial Nerve to AH Train of Four)

TITLE: Cascade Train of Four Quick Setup P/N: N/A

AUTHOR: Elizabeth Huber

DATE: 9/18/14

PAGE 2

General Settings Summary:

Channel Setup Gain 200uV to 500uV for foot - or - 500uV -2000uV for hand

Mode = Train of Four, viewed with Train of four analysis

Median nerve stimulation with APB recording (hand)

AH recording may also be used (foot)

Time base = 3ms/div (for a more compressed appearance, use a higher time base number)

Display gain = 2,000 uV/Div (foot) or 5,000 uV/Div (hand)

Stimulator = ~ 18mA hand and ~20-50mA for foot (stimulus intensity varies according to

stimulator placement and health of nerve) Note* over stimulating can cause a decreased CMAP

amplitude

Stimulator duration 200uS hand and may be increased to 300uS for foot

Settings Examples for Tibial to AH TO4:

TITLE: Cascade Train of Four Quick Setup P/N: N/A

AUTHOR: Elizabeth Huber

DATE: 9/18/14

PAGE 3

TITLE: Cascade Train of Four Quick Setup P/N: N/A

AUTHOR: Elizabeth Huber

DATE: 9/18/14

PAGE 4

Miscellaneous Adjustments:

If waveforms are clipping, try changing display gain to a higher number such as 10,000uV/div. If that

doesn’t work, try changing channel setup gain to a higher number such as 2000. Try display gain first.

If waveforms are too small, try changing display gain to smaller number such as 2,000uV/div, then

1,000/uV/div and so on. If necessary, change channel setup gain to 2000uV/div or smaller.