The intention is amazing
I’m an anesthesiologist, and the accelerometer and the sensor for mechanomyography does not always work quite well in our institution. Would you mind if we study the efficacy of this app on our patients?
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This application uses a smartphone's accelerometer to measure the train-of-four (TOF) ratio, a critical metric for assessing neuromuscular blockade during anesthesia. It provides an accessible alternative to traditional, less available measurement devices, aiding anesthesiologists in safer patient care.
✓TOF ratio measurement
✓Uses iPhone accelerometer
✓Assesses neuromuscular blockade
✓Aids in extubation safety
✓Developed by medical professionals
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What's New in Train of Four
2.0
September 30, 2026
Rebuilt from the ground up, with the published measurement unchanged. • A clearer paper: T1 to T4 as bands, each peak marked and valued in g • T4/T1 to two decimals, with the two peaks it is made of • The four twitches as bars, as a percentage of T1 • Scroll back through the last ten minutes while recording continues • Save readings and chart T4/T1 across a reversal • Export readings and raw accelerometer data as CSV • How to Use: the palm strap, the method, and the study in the Canadian Journal of Anesthesia
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FAQ
What is the primary function of Train of Four?
Train of Four is designed to measure the train-of-four (TOF) ratio, a key indicator for neuromuscular blockade during general anesthesia. It helps anesthesiologists assess when it is safe to extubate a patient.
How does Train of Four measure the TOF ratio?
The app utilizes the built-in accelerometer of an iPhone or iPod to measure the force of muscle twitches during TOF stimulation, providing an alternative to traditional mechanomyography devices.
Is Train of Four suitable for all devices?
Train of Four is currently supported on iPhone and iPod devices. It is rated for ages 4 and up, making it accessible for a wide range of users.
What is the TOF ratio considered safe for extubation?
A TOF ratio greater than 0.9 is generally considered safe for extubation of an endotracheal tube and indicates complete reversal from neuromuscular blockade.
What is the update frequency for Train of Four?
Train of Four was last updated on August 20, 2015, with version 1.0. Further updates would depend on the developer's ongoing development plans.
What are the user reviews like for Train of Four?
Train of Four has received excellent user feedback, boasting a rating of 4.8 stars from 4 ratings, indicating high user satisfaction with its functionality.
Does Train of Four have ads?
No, Train of Four does not contain advertisements. It is a completely ad-free application for users.
What is the price of Train of Four?
Train of Four is available for free. There are no costs associated with downloading or using the application.
