By Aatif M. Husain
A sensible method of Neurophysiologic Intraoperative Monitoring covers all points of neurophysiologic intraoperative tracking (NIOM), that is more and more getting used to constantly determine the sensible integrity of a sufferer s anxious approach in the course of surgical procedure. With education in NIOM seldom on hand in conventional courses, this booklet is the single useful resource for crucial details at the scientific perform of NIOM.
The publication is split into handy sections: part One, easy rules, covers the modalities utilized in tracking in addition to the infrequently mentioned issues of distant tracking, billing, moral concerns, and a purchaser s consultant for constructing a laboratory. part reports anatomy, body structure, and surgical procedure of many of the approaches, by way of information of the tracking modalities and their interpretive standards.
Special beneficial properties include:
• Portability: effortless to hold and use
• comprises all significant sorts of surgical procedures for which NIOM is requested
• details on deciding to buy, education, set-up, and billing that isn't on hand anyplace else
• a distinct technical part on the finish of every bankruptcy that stories the logistics of tracking a selected form of surgery
• important for trainees and skilled clinicians
With large use of bullet issues, tables, and illustrations, this handbook is vital analyzing for neurologists, neuroanesthesiologists, neurosurgeons, and OR techs.
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Extra resources for A Practical Approach to Neurophysiologic Intraoperative Monitoring
Usually the technologist will carry a small toolbox, apron, or bucket with supplies needed for any situation. The most important of all is, of course, electrodes. Available electrode types include disposable needles, disposable foam pads, reusable gold cups, corkscrew needles, and a variety of other electrodes found in many supply catalogs. 1. This is not meant to be an exhaustive list but should be a good start for the beginning technologist. Setup The type and site of surgery being performed will determine the type of monitoring that is needed.
It is the monitoring team’s duty to identify the location, pattern, intensity, and duration of this activity and then communicate it to the surgeon when appropriate. At least as important as the type of EMG activity is the relation to surgical activity at the time of occurrence. Thus, the neurophysiologist must maintain awareness of surgical events and give feedback immediately upon occurrence, so that the surgeon understands the relationship of EMG to his or her activities. Short bursts of activity and low-frequency trains of activity are usually, at worst, lowlevel irritation with a low risk for persisting injury.
J Clin Neurophysiol 2002;19:387–395. Husain 01 1/17/08 11:51 AM Page 20 Husain 02 1/17/08 11:52 AM 2 Page 21 Basic Neurophysiologic Intraoperative Monitoring Techniques Robert E. Minahan Allen S. Mandir monitoring is most effective in cases where nerve injury results from repetitive mechanical irritation of a nerve. T his chapter discusses and introduces the basic techniques of neurophysiologic intraoperative monitoring (NIOM). Techniques for electromyography (EMG), motor nerve conduction studies, somatosensory evoked potentials (SEPs), motor evoked potentials (MEPs), brainstem auditory evoked potentials (BAEPs), and electroencephalography (EEG) are all discussed.
A Practical Approach to Neurophysiologic Intraoperative Monitoring by Aatif M. Husain