Triggered EMG Signal Loss For Thyroidectomy, Big Whoop?
Triggered EMG for Total Thyroidectomy In one of my previous post, I wrote about monitoring the recurrent laryngeal nerve with triggered EMG and the possibility of giving the surgeon misinformation. That misinformation (in that hypothetical scenario) could lead the...
Facial Nerve Monitoring And The Nervus Intermedius
Possible Facial Nerve Monitoring Blunder... Facial nerve monitoring is one of the things that we as intraoperative neurophysiologist can perform with a high level of certainty Because of the amount of research demonstrating its usefulness, the information we give back...
How To Get An IOM Job
Land Your First IOM Job It's the weirdest thing... IOM companies are always looking to hire someone with at least a CNIM and 3 years experience while so many people are always wondering where to find their first IOM job. There's always that initial barrier to get...
Just Some Random Thoughts On MEPs
I came across some papers on motor evoked potentials (MEPs) that got me thinking a little bit. It got me thinking about small influences in the operating room that may, or may not, affect our tracings during our cases. Specifically, MEPs. Here're some snippets from...
SSEP Baseline: When Do You Set Your Final Baselines?
SSEP Baseline One of the few things in IONM that's agreed upon (well, mostly anyways), is that an amplitude reduction of 50% in SSEP baseline, or a 10% latency shift off of those somatosensory evoked potential baselines, is a reliable alarm criterion to use during...
Visual Evoked Potentials – A Different Approach
When talking about intraoperative monitoring of visual evoked potentials, it's almost like you're getting a history lesson, seeing as most groups aren't doing them. And most have 2 things that come to mind right away. First, visual evoked potentials have been used for...
Peripheral And Cranial Nerve Monitoring – Clinical Uses Part 2
Cranial Nerve Monitoring... Continued In the last post, Cranial and Peripheral Nerve Monitoring - Clinical Uses Part 1, I went over a scenario where an unanticipated postoperative problem occurred due to poor neuromonitoring. The SNP's feedback led the surgeon to...
Peripheral And Cranial Nerve Neuromonitoring – Clinical Uses Part 1
In peripheral and cranial nerve neuromonitoring cases, we are often asked to monitor those specific nerves and corresponding end organs. Many surgeons are using us for information in regards to EMG activity signifying nerve root injury or irritation. Others are using...
DABNM exam written portion vs CNIM exam… The Same Thing?
DABNM Written Exam = CNIM Exam? Like most areas of healthcare, IOM practitioners are divided into classes due to credentials. One thing that's a little weird about IOM is the fact that the CNIM exam and the DABNM exam (written portion) seem to cover a lot of the same...