by Joe Hartman | Nov 9, 2016 | Neuromonitoring Training
How Resourceful Of A Neuromonitoring Tech Are You? First off, let me start this topic off by saying that I’m not a big fan of the term neuromonitoring tech (I prefer surgical neurophysiologist or SNP). But I really want to address those in the field that might... 
by Joe Hartman | Nov 8, 2016 | IOM Jobs
The Road To A Successful Surgical Neurophysiologist Career Whenever I speak to people looking to get into neuromonitoring, I try to give them advice that will help them make a decision beyond starting their surgical neurophysiologist career. This is a career, not a... 
by Joe Hartman | Nov 7, 2016 | Neuromonitoring Study Guides
DABNM Prep Strategies – Answering “Why” and, “Says Who?” One of the challenges faced by those taking on a DABNM question is that you not only have to be able to answer “why,” but also “says who.” That ends up being a lot of information to cram in there. One... 
by Joe Hartman | Nov 4, 2016 | Neuromonitoring Study Guides
How to study for the CNIM exam and PASS! (Joe’s Notes: A part of my brain fails to comprehend the vast differences in backgrounds people in the IONM community have and the fact that many of the readers are just starting their IONM career. I end up jumping into... 
by Joe Hartman | Nov 3, 2016 | Neuromonitoring Training
Loss of Cortical SSEP Due To Loss of Receptor Activation Earlier in this 30 Days of Neuromonitoring series, I wrote about cortical and subcortical reorganization after a loss of afferent feedback from carpal tunnel syndrome and how that affects intraoperative... 
by Joe Hartman | Nov 2, 2016 | Neuromonitoring Training
The CNIM vs The Intraoperative Neuromonitoring Degree (Joe’s notes: This is a GUEST POST by Josh Mergos, who is the director of the Intraoperative Neuromonitoring Program at the University of Michigan – School of Kinesiology. We met for the first time... 
by Joe Hartman | Nov 1, 2016 | Neuromonitoring Study Guides, Pass The CNIM, Pass The DABNM
Intraoperative Neuromonitoring List There always seems to be a couple things that get people on the CNIM exam, and I’ve compiled a neuromonitoring list. First is the little extra’s that we don’t think about much when we’re in the OR. These are a little easier to... 
by Joe Hartman | Oct 31, 2016 | Neuromonitoring Study Guides
Should I Sit For The D.ABNM? I get an email about once a month asking me the same question… Is the D.ABNM worth the headache? The overall message I try to give is that… Yes, it has helped my career and there is a very good chance it will do the same for you. Work hard... 
by Joe Hartman | Oct 28, 2016 | Neuromonitoring Training
Optimizing Sub-cortical SSEP There is 1 electrode that I see get misused in somatosensory evoked potentials more so than any other electrode in any modality. This is the electrode placed over the cervical spine (or sometimes around the ear or mastoid) and generally... 
by Joe Hartman | Oct 27, 2016 | Neuromonitoring Training
The Trapezius Muscle In Intraoperative Neuromonitoring If we follow the same medical textbooks we used in school to pass a test, then we know for sure that the motor portion of the trapezius is innervated by the spinal accessory nerve (CN 11) and the sensory portion... 
by Joe Hartman | Oct 26, 2016 | Neuromonitoring Training
Monitoring Train Of Four During Surgery From the perspective of the anesthesiologist, one of the benefits of having a surgical neurophysiologist monitor during surgery is a more precise measurement of muscle relaxation or train of four monitoring. In some of the... 
by Joe Hartman | Oct 25, 2016 | Neuromonitoring Study Guides
Post-auricular Muscle Artifact In BAER This is a question that I got about post-auricular muscle artifact on intraoperative brainstem auditory responses. These are one of those responses that I don’t have any of my own images because I’ve never seen it live. This is... 
by Joe Hartman | Oct 24, 2016 | Neuromonitoring Training
Non-Compete Clauses In Intraoperative Neuromonitoring (Joe’s notes: In today’s GUEST POST I interview Greg Barthelette, a lawyer in Boca Raton, Florida. Greg practices in a few different areas, most important to us is business law. I’ve used his services... 
by Joe Hartman | Oct 21, 2016 | Neuromonitoring Training
Carpal Tunnel Considerations In Neuromonitoring In the neurodiagnostic world, evaluating carpal tunnel syndrome is one of their bread-and-butter studies. For surgical neurophysiologist who works in the operating room, the topic of median nerve compression at the wrist... 
by Joe Hartman | Oct 20, 2016 | Neuromonitoring Training
IONM Manager: 7 Ways To Get A Neuromonitoring Management Position There are far fewer neuromonitoring management positions available than there are clinicians that want them. If you’re working for a smaller contract company or in-house neuromonitoring group, you’ll... 
by Joe Hartman | Oct 19, 2016 | Neuromonitoring Training
Propep Surgical: Pudendal Nerve Neuromonitoring During Prostatectomy (Notes from Joe: Neuromonitoring used during prostatectomies has always made sense to me, so things made sense when Jann Rasmussen from Propep surgical talked to me about his new business venture.... 
by Joe Hartman | Oct 18, 2016 | Neuromonitoring Training
Is SSEP Improvement Sensitive For Detecting Complete Decompression Of The Spinal Cord Or Nerve Root? In an article that I wrote years ago, titled Brainstem Auditory Evoked Potential Used To Predict The Need For Duraplasty In Chiari Malformation Type I Decompression, I... 
by Joe Hartman | Oct 17, 2016 | Neuromonitoring Training
Steps To Becoming A Surgical Neurophysiologist (Guest Post) Joe’s Notes: I don’t really ever write it after my name anymore, but I am also an OTR (Registered Occupational Therapist). If I would have stopped there, I don’t think I would have learned about... 
by Joe Hartman | Oct 14, 2016 | Neuromonitoring Training
Tools of the Neurophysiologist – Spectral Analysis and Bandpass Filters (Joe’s notes: This guest post is written by Tom Epplin-Zapf on a topic that might be considered one of the field’s Achilles heel (or at least complaints from people after taking the... 
by Joe Hartman | Oct 13, 2016 | Neuromonitoring Training
Everyday Neuromonitoring With Anesthesia Conversations… Everyone has their own experiences working with anesthesiologist and CRNAs. At some facilities, the neuromonitoring clinician tells the anesthesia team what they need, and anesthesia accommodates. At other... 
by Joe Hartman | Oct 12, 2016 | Neuromonitoring Training
Intraoperative Bulbocavernosus Reflex Surgeon: Isn’t there anything else you can do to monitor the sacral nerve roots? That’s the area I’m most concerned about today… Me: Well, there’s the intraoperative bulbocavernosus reflex. That would monitor the pudendal nerve up... 
by Joe Hartman | Oct 11, 2016 | Neuromonitoring Training
Optimization Tip: How To Use ABR Click Polarity Wisely… Brainstem auditory evoked potentials can be a pain. Sometimes downright frustrating. Their saving grace is that anesthesia is really going to have to go out of their way to mess up the responses. We might... 
by Joe Hartman | Oct 10, 2016 | Neuromonitoring Training
Intraoperative EEG For Depth of Anesthesia? There seems to be some confusion on the effectiveness of intraoperative EEG being able to determine some sort of depth of anesthesia. We seem to find ourselves in this scenario far too often… “My blood... 
by Joe Hartman | Oct 7, 2016 | Neuromonitoring Training
Selective Dorsal Rhizotomy Using Intraoperative Neuromonitoring (Guest Post) (Joe’s notes: This guest post, written by Kristina Young, covers one of those case types where you know you’re going to be part of the surgery today. For a lot of our... 
by Joe Hartman | Oct 6, 2016 | Neuromonitoring Study Guides
“Can you go over Sensitivity-Specificity, and what that actually means for us in the operating room?” Sensitivity-Specificity I think the second part of that question is the most important (what’s that mean for us in the OR). If you’re taking the... 
by Joe Hartman | Oct 5, 2016 | IOM Jobs
Experienced Surgical Neurophysiologist Are In Demand – If You Can Prove Your Value. At the time of this writing, most neuromonitoring companies feel that there is a shortage of experienced surgical neurophysiologist in the applicant pools. Or at least seasoned... 
by Joe Hartman | Oct 4, 2016 | Neuromonitoring Training
Saphenous SSEP For Protection Of The Femoral Nerve During Transpsoas Lateral Interbody Fusion. Not too long ago, lateral interbody fusion procedures really started to pick up in popularity. Some large studies came out that showed you could fuse the spine with less... 
by Joe Hartman | Oct 3, 2016 | Neuromonitoring Training
D-wave And Dorsal Column Mapping Training Here’s the reality for people that want to get trained on doing d-wave and dorsal column mapping on spinal tumors… you most likely aren’t going to have the luxury of seeing 30 of these before you start doing... 
by Joe Hartman | Sep 29, 2016 | Neuromonitoring Training
It has been a long time since I posted articles here on a regular basis. But that’s all going to change here shortly. Watch the video for... 
by Joe Hartman | Aug 27, 2014 | Neuromonitoring Training
The G0453 Code ATTENTION: This Needs To Be Handled By 9/2/2014 (EDIT: Action time is over to kill the G0453, but still worth the read) Neuromonitoring professionals have been waiting to see how Medicare’s new G code (G0453) is going to affect the way we deliver our... 
