by Joe Hartman | Sep 22, 2022 | Guides
This is your guide to understanding the field of intraoperative neuromonitoring, from the perspective of a patient, surgeon, or potential surgical neurophysiologist. It will cover exactly what intraoperative neuromonitoring is, who can do it, how it’s done, and... 
by Joe Hartman | Sep 19, 2022 | Neuromonitoring Training
Hypoglossal Nerve Stimulation: A Novel Technique for IONM This isn’t our first time helping surgeons map out nerves. We are starting to see some traction in hypoglossal nerve stimulation for obstructive sleep apnea. Obstructive sleep apnea is one of the most... 
by Joe Hartman | Sep 12, 2022 | Something Different
Blasphemy! I wasn’t intending to do a follow-up post, but I’ve been catching some heat lately. Comments. Text. Even phone calls. You know something just hit the fan if people actually use their phone to call you. I touched a nerve when I called the CNIM a... 
by Joe Hartman | Sep 8, 2022 | Neuromonitoring Training
What Does Your IONM Resume Say About You? Let’s break down the neuromonitoring field a little bit here (it will help your IONM resume not suck)… If you had to guess what percent of the cases your company monitors are spine cases, where would you place your... 
by Joe Hartman | Aug 25, 2022 | Neuromonitoring Training
Beliefs Are Identities In hindsight, it was obvious. It almost always is. But this one seems like a real head smacker. I don’t need any modern equipment; 30 minutes and a playground and my 2 boys will make a bulletproof case for handwashing. Their fingernails... 
by Joe Hartman | Aug 22, 2022 | Something Different
What Is Your CNIM Worth? Imagine this: You go to school for 4+ years — purposely putting yourself into debt — only to realize the job you want only overlaps this expensive education on the margin. So far, you’re in pretty good company with most... 
by Joe Hartman | Apr 26, 2022 | Neuromonitoring Training
Remember a couple of years ago when we would all meet up at IONM conferences to share ideas and network in real life? Well, I’m venturing off to my first one since COVID-19 hit. This year’s ASNM annual meeting is in Clearwater, Fl on May 20th and... 
by Joe Hartman | May 10, 2021 | Neuromonitoring Training, Something Different
Signal Improvements In tcMEP and SSEP During Spine Surgery What does everyone want for IONM? Needless recording electrodes and cordless monitoring equipment. Both would be great — if it actually worked like the alternative. But I can’t be alone in... 
by Joe Hartman | Sep 10, 2020 | Something Different
It’s easy to see that COVID-19 caused a neuromonitoring training problem, but did you know we have a chicken sexer problem too? I owe you an explanation for that one. But before I explain myself, let me tie it into some of my past post. In a couple of recent... 
by Joe Hartman | Jul 15, 2020 | Neuromonitoring Training
The surgeon uses navigation and wants to know why she should use motor mapping for her crani? That’s the question posed to me by a clinician years ago. It was just before I set up my case and they recruited me into the conversation. So I walked over to the room... 
by Joe Hartman | Jun 24, 2020 | Something Different
If you don’t have your CNIM (or can remember when you didn’t) there’s a difficult truth to face: it’s hard to get hired unless you already have your CNIM and can’t get it unless you get hired. But that’s really just the first... 
by Joe Hartman | Jun 8, 2020 | Something Different
In 2016, I wrote What To Expect From The Neuromonitoring Field In The Future? right after the elections. As we find ourselves in another election year — and in what’s probably still the first inning or 2 of the COVID-19 outbreak — it seems like the... 
by Joe Hartman | Mar 24, 2020 | Something Different
NOTE: At the time of this writing, we’re on the front side of the Coronavirus outbreak. I prefer to only write timeless over timely material, but there are certain moments in history that affects our IONM community. This one feels really, really different. Our... 
by Joe Hartman | Jan 16, 2020 | Something Different
There’s a quote that goes something like this: “what’s the definition of conflict? Two people in the same zip code…” Why? Because we’re programmed for it. We prioritize survival and reproduction over everything else. Contrast is an... 
by Joe Hartman | Dec 30, 2019 | Something Different
I was asked to give a talk this year at an ASNM meeting in Tampa. The topics requested were all in the area of “things most people are afraid to do, so not spine or craniotomies.” That left the door open and I decided to focus more on helping solve the... 
by Joe Hartman | Dec 30, 2019 | Something Different
I have to admit, the first decade of my IONM career aimed at better. Not stick-my-nose-in-the-air better, just better than I was yesterday. Better is hard — painful at times. You sometimes have to work hard on things when you’d rather not. There’re... 
by Joe Hartman | Dec 20, 2019 | Something Different
Fortunes are made and lost on the back of volatility. If you were a day trader with investment velocity as a strategy, you’d pay less attention to the megacorps in a slow-growth sector. The seas are too calm. There are no white caps to identify before the break... 
by Joe Hartman | Nov 26, 2019 | Something Different
If you’re in America (this might be happening elsewhere, too), the world we live in feels a little different. Information flow was previously more limited and therefore controlled: the general consensus was familiar and comfortable. Opinions and understandings... 
by Joe Hartman | Dec 4, 2018 | Neuromonitoring Training
How To Have A Neuromonitoring Discussion One of the reasons for starting this website was to make sure I was part of the neuromonitoring conversation. It was a decision I made early in my career… and I’m glad I did. Hearing the different perspectives and... 
by Joe Hartman | Nov 29, 2018 | IOM Jobs
In Response To High Earning Surgical Neurophysiologist Being The Best At Sales [Joe’s notes: This is a guest post – or really a response to my previous post – that was insightful and, well, long enough to turn it into its own blog post instead of a... 
by Joe Hartman | Nov 1, 2018 | IOM Jobs
Surgical Neurophysiologist Jobs That Pay Looking back over the past decade of money being paid to a neuromonitoring technologist, there’s been some waxing in waning in the surgical neurophysiologist salary category as to who deserves the higher salary. 10+ years... 
by Joe Hartman | Apr 3, 2017 | Neuromonitoring Training
Recording Electrodes For EMG in the Operating Room: Referential or Bipolar? If your IONM manager walked into the OR in the middle of your case, took a look at your intraoperative EMG traces and started questioning your setup, could you defend yourself? I try to do... 
by Joe Hartman | Feb 16, 2017 | Neuromonitoring Training
BAER (Brainstem Auditory Evoked Potentials) During Microvascular Decompression Surgery You might remember when I was complaining about using ABR in the operating room and how to adjust the click polarity to help obtain a more reliable BAER. But my first gripe, having... by Joe Hartman | Jan 5, 2017 | Neuromonitoring Training
Goodbye To The Neuromonitoring Forum One area of the website that I thought had the most potential to be an asset for the IONM community was the neuromonitoring forum. But it has been several months now and it is still a complete ghost town. I’m honestly not too... 
by Joe Hartman | Jan 3, 2017 | Neuromonitoring Training
Minimally Invasive Fusion of the Sacroiliac Joint Using EMG Nerve Monitoring EMG nerve monitoring in lumbar surgery makes up a large percentage of cases monitored every year. Using EMG nerve monitoring during SI joint fusions seems to be less utilized, even though the... 
by Joe Hartman | Dec 19, 2016 | IOM Jobs
Surgical Neurophysiologist or Medical Doctor? There seems to be more than a handful of people that want to go to medical school but decided to get into intraoperative neuromonitoring in the meantime. Others are on the fence as to where they should take their career... 
by Joe Hartman | Dec 5, 2016 | Neuromonitoring Training
SNP’s Performing A Physical Exam: Who Should Do It And Who Shouldn’t… Before any case is monitored, all pertinent patient history, signs, symptoms, physical exam findings and diagnostics should be gathered, documented and relayed to any oversight... 
by Joe Hartman | Nov 22, 2016 | Neuromonitoring Training
Levetiracetam And Its Effects On Transcranial Motor Evoked Potentials During Surgery Levetiracetam (AKA Keppra) It’s pretty widely accepted that inhalational agents and muscle relaxants will reduce the effectiveness of transcranial motor evoked potentials during... 
by Joe Hartman | Nov 11, 2016 | IOM Jobs, Neuromonitoring Training
What To Expect From The Neuromonitoring Field In The Future? Anyone else want to make some predictions about the neuromonitoring field? Let’s talk about what we can expect out of neuromonitoring in the near future. This line of conversation seems to come up a... 
by Joe Hartman | Nov 10, 2016 | Neuromonitoring Training
Double-Train MEP On A Comeback Kick Using transcranial electric motor evoked potentials in the operating room has become routine practice for spinal cord monitoring. Recent improvements in the ability to record tcMEP have resulted in increased use during other...
