By Aatif M. Husain MD
A pragmatic method of Neurophysiologic Intraoperative tracking covers all facets of neurophysiologic intraoperative tracking (NIOM), that's more and more getting used to regularly examine the sensible integrity of a sufferers fearful process in the course of surgical procedure. With education in NIOM seldom to be had in conventional courses, this ebook is the one sensible resource for crucial details at the scientific perform of NIOM. The ebook is split into handy sections: part One, easy rules, covers the modalities utilized in tracking in addition to the hardly ever mentioned themes of distant tracking, billing, moral concerns, and a buyer's consultant for developing a laboratory. part stories anatomy, body structure, and surgical procedure of some of the approaches, through info of the tracking modalities and their interpretive standards. detailed positive factors comprise: Portability, effortless to hold and use comprises all significant forms of surgical procedures for which NIOM is asked details on purchasing, education, set-up, and billing that isn't on hand wherever else a different technical part on the finish of every bankruptcy that studies the logistics of tracking a selected form of surgical procedure beneficial for trainees and skilled clinicians Value-priced at $75.00! With vast use of bullet issues, tables, and illustrations, this pocket-sized handbook is key analyzing for neurologists, neuroanesthesiologists, neurosurgeons, and OR techs. (20100503)
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Additional info for A PRACTICAL APPROACH TO NEUROPHYSIOLOGIC INTRAOPERATIVE MONITORING
Signals returned as decompression was achieved. Interpretation The most commonly used criteria for identifying a significant degradation of the SEPs are drop in amplitude below 50% of the baseline and/or a latency prolongation of 10% over the baseline value. These criteria are based on clinical experience and standards may vary among NIOM groups. Application of these “standard” criteria may need to be modified in cases where signals are of poor initial quality or where confounding systemic factors exist, such as alteration of anesthetic gases, low level of neuromuscular blockade, dramatic blood loss, or other metabolic derangements.
2 Example of artifact caused by electrocautery. This was seen when tibial somatosensory evoked potentials were being averaged. 3 A cardiopulmonary bypass machine. This machine can also be used to administer anesthetic agents and other drugs as well as for inducing hypothermia. 4 An operating surgical microscope. During surgery, this microscope will be draped with sterile sheets. the microscope moving in and out of the field. There is rarely an artifact problem related to the microscope. The microscope will be sterile and draped prior to the start of the case and should not be touched once draped.
During x-rays, including those taken with the C-arm (fluoroscopy), the technologist should either exit the room or wear lead protection covering at least the reproductive organs and thyroid. Gloves should always be worn when handling a patient, as this is fundamental to universal precautions. Infection Control The NIOM team should always practice universal precautions for infection control. If needle electrodes are being used, the skin should be prepped with alcohol skin prep. Needle electrodes are for a single use only and should be disposed of in a sharps container.