Central New Mexico Community College



Central New Mexico Community CollegeElectroneurodiagnostic Technology Program (ENDT)Program Handbook 2019-2020Created: July 26, 2019 revised 1/19/2021Introduction to CNM ENDT Program HandbookThe purpose of the CNM ENDT Handbook is to serve as a reference and resource for students in CNM ENDT program. The CNM ENDT program Handbook has important documents that provide guidance to students and help them succeed. Other documents with policy and procedure information include: the CNM ENDT catalog online at m.edu/ENDT.Important notice to students:All students accepted to the CNM ENDT Program in HWPS are bound by all program policies. By enrolling, every student acknowledges their responsibility to abide by and adhere to all institutional and programmatic policies and procedures. Students therefore are responsible with becoming familiar with the Program Handbook and the CNM ENDT Catalog online at m.edu/ENDT. Table of ContentsIntroduction to Program Handbook……………………………………………………………………………………………….2Important program information provided in the catalog……………………………………………………………………….………………………….5Program description………………………………………..…………………………………..5Mission, Vision and Goals……………………………………………………………………..5Program Objectives……………….…………………………..…………….………………….5Staff and Faculty………………………………………………………………..……………...5Program Accreditation/Approvals……………………………………………………………..6Graduation Requirements………………………………………………………………….…..6Academic Calendar……………………………………………………..……………………...6Admission Information………………………………………………………..……………….7Course List & Descriptions……………………………………………………………………7Grading & Satisfactory Academic Progress Requirements…………………………………………………………………………….……7Background Checks/Vaccine Information……………………………………………………7Professional Code of Ethics………………………………….……………………………….8Clinical course Compensation………………………………………………………………………...9Electronic Device Policy……………………………………………………………………………...9Student Conduct/Academic Integrity ………………………….……………………………………..9Communication Policy …………………………………………………………………………….…9Absences …………………………………………………………………………………….10Tardiness……………………………………………………………………………………..10Outside Employment ……………………………………………..………….………………………11Inclement Weather Policy………………………………………..……………………………….……………………….11Required Textbooks……………………………………….………………………………………….11Dress Code …………………………………………………………………………………………...11Advisory Board……………………………………………………………………………………….11Information on National Certification Exam………………………………………………………………………………………………….12Physical Requirements ……………………………………………………………………………….12Medical Conditions…………………………………………………………………………………...12Appendix I Supplemental Training Materials-Head lice (Pediculosis)....…………….…………....13-15Appendix II Neurodiagostic Technology Program Graduate Competencies………………………16-19Appendix III: Evaluations (Instructor, clinical site, student)……………………………………….Important ENDT Program Information Provided in CatalogThe CNM HWPS catalog contains important information about this program. Program descriptionThe Electroneurodiagnostic Technology (NDT) program offers courses designed to provide students with the education, technical skills, and clinical experience necessary for a career as an EEG Technologist. EEG Techs are healthcare professionals who apply electroencephalography, a recording of ongoing neural electrical activity, to assist physicians in treating neurological and seizure disorders. EEGs evaluate the function of the nervous system and may be performed on all patient populations from neonate to geriatric and for a variety of durations from 30 minutes to multiple days. According to the U .S. Bureau of Labor Statistics, the field of electroencephalography will grow 23% by 2024, representing a critical need for credentialed professionals at all levels of certification.This program provides didactic lecture and skills laboratory instruction as well as hands-on clinical experience in both the outpatient and inpatient settings through the University of New Mexico Hospital Neurodiagnostic Lab and Presbyterian EEG lab. The successful graduate will be able to apply and record EEGs, provide appropriate patient care, evaluate and describe normal and abnormal neural waveforms, and maintain equipment as crucial members of a comprehensive medical team. Upon completion of this program, students will be prepared to take the board exam for national certification through the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET). Passing this national exam will result in a Registered EEG Technologist (REEGT) credential and qualification to progress to expanded levels of Neurodiagnostic testing.Mission, Vision and GoalsVision: The CNM ENDT Program will be the leading training program for Neurodiagnostics with recognition for excellence by local, state and national organizations. Mission: Build lives and community by filling a need for EEG techs in local and regional communities. Goal: To train and prepare students to graduate with competence in skill, knowledge and professionalism to perform EEG’s as Registered EEG technicians. Program ObjectivesWhen students complete the program they will be able to perform an electroencephalogramTo prepare competent entry-level neurodiagnostic technologists in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domainsWhen students complete the program they will be able to display appropriate attitude and professional behavior as a healthcare team member.When students complete the program the EEG technologist has a working knowledge of seizure manifestations, classifications, and EEG correlates; medication effects on the EEG background and waveforms, signs, symptoms, and EEG correlates for adult neurological disorders, psychiatric and psychological disorders and EEG correlates, neonatal and pediatric EEG, ECI and correlate patient history and clinical symptoms with appropriate electrode application and recording parameters. Staff and FacultyProgram OfficialStephanie Jaramillo, MHA, ReegT, CNIM-Program DirectorProgram Part-Time FacultyTodd Chancey, ReegTKate Cavanagh, ReegTCatherine Calder, ReegTPatricia Villa, ReegTJeanne Van Amburg, ReegTProgram Accreditation/ApprovalsCoA-NDTCommittee on Accreditation for Education in Neurodiagnostic Technology-In Application ProcessGraduation RequirementsThe program has a completion ceremony for each graduating class in addition to the CNM commencement ceremony. All graduating ENDT students are strongly encouraged to participate in both.Upon completion of this program, students will be prepared to take the board exam for national certification through the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET). Passing this national exam will result in a Registered EEG Technologist (REEGT) credential and qualification to progress to expanded levels of Neurodiagnostic testing.Academic CalendarDescriptionStatusDateObservance Independence Day HolidayClosedJuly 3, 2020Non-Instructional Days?July 4-5, 2020Last Day of Summer Term?August 9, 2020First Day of Intersession?August 10, 2020Employee Convocation(Half-Day AM Closure)August 28, 2020Last Day of Intersession?August 30, 2020First Day of Fall Term?August 31, 2020Labor Day HolidayClosedSeptember 7, 2020Thanksgiving HolidayClosedNovember 26 - 27, 2020Non-Instructional Days?November 28 - 29, 2020Last Day of Fall Term?December 13, 2020Non-Instructional Days?December 14 - 20, 2020Winter BreakClosedDecember 21, 2020 - January 3, 2021First Day of Intersession?December 21, 2020Non-Instructional Days?January 4, 2021 - January 10, 2021Last Day of Intersession?January 10, 2021First Day of Spring Term?January 11, 2021Martin Luther King, Jr. HolidayClosedJanuary 18, 2021Last Day of Spring Term?April 25, 2021First Day of Intersession?April 26, 2021Commencement (Tentative)?May 1, 2021Last Day of Intersession?May 16, 2021First Day of Summer Term?May 17, 2021Memorial Day HolidayClosedMay 31, 2021Non-Instructional Days?July 3 - 4, 2021Observance of Independence Day HolidayClosedJuly 5, 2021Last Day of Summer Term?August 8, 2021First Day of Intersession?August 9, 2021Employee Convocation(Half-Day AM Closure)August 27, 2021Last Day of Intersession?August 29, 2021First Day of Fall Term?August 30, 2021Labor Day HolidayClosedSeptember 6, 2021Admission Information2020-2021 Cohort II the ENDT program will be a formal Coordinated Program Entry (CPE). Here is the website where student entry requirements are listed. Course List & DescriptionsThe ENDT program offers two pathways, an Associate of Applied Science or a Post-Degree Certificate of Completion.Associate of Applied Science Certificate of Completion & Satisfactory Academic Progress RequirementsThe final clinical grade for each term will be described in each clinical course syllabus. The grading scale for all clinical courses is as follows: A=90-100%, B=89-80%, C=79-70%, D=69-60%, F=59% or lessClinical attendance: All clinical courses have graded attendance policies. See Absences or tardiness. Clinical Scheduling: The majority of clinical shifts will occur Monday through Friday during the day. Examples of shifts include, but are not limited to: 7:00 AM to 3:00 PM, 2:30 PM to 10:30 PM, 11:30 PM to 6:30 AM. Schedules are determined well in advance to give the students ample time to make necessary arrangements to attend their assigned clinical times. Students are responsible for their own travel arrangements to and from their assigned clinic sites.Term 2 (spring): 180 hours/termTerm 3 (summer): 180 hours/termTerm 4 (fall): 180 hours/termProcedures for Assessing Clinical Task Verifications:Competence-based standards are made up of performance criteria by which requirements for the qualification of Registered EEG Technologist may be assessed in the ABRET exam. This will be accomplished by formative and summative evaluation of clinical performance, underpinning knowledge and understanding, covering the full range of activities expected of a Registered EEG Technologist.Background Checks/Vaccine InformationEach student must have a current CPR certification (American Heart Association HealthCare Provider or American Red Cross CPR for the Professional Rescuer) prior to entering their first clinical experience. During orientation, we will review the following clinical compliance requirements. You are not required to complete these prior to your orientation. We will provide paperwork and due dates during your orientation session.Fingerprinting for Caregivers Background Check: Fingerprinting is required to complete the NMDOH Criminal Caregivers background check. Fees for this service are paid through your student program fees.Immunizations: Verification of several vaccinations will be required.Drug Screening: Students are required to undergo a routine drug screening prior to starting the program or prior to beginning their clinical experience.Healthcare Provider CPR Card: Copies of all the cards you received in the Health 1001 course will need to be turned into the Office of Verification & Compliance.Hospital Specific Requirements: Many students will attend clinicals at multiple locations. As a result there will be computer based training and in-class computer trainings that you will be required to complete.Although students are not required to have health insurance, it is highly encouraged. Students should be aware that some clinical education sites require students to have health insurance.Professional Code of EthicsThis program has been designed to provide a rewarding career and build community. ?Neurodiagnostics encompasses so much more than just administering an EEG and, therefore, participating in this program, is a commitment to professionalism. ?Professionalism consists of being respectful, mature, having personal integrity, and taking personal responsibility for your success in this course.The instructors of the Electroneurodiagnostic program serve as guides to your learning. ?We are here to help you understand best practices during your online and clinical teaching and help you become prepared to take the board exam for national certification through the American Board of Registration of Electroencepalographic and Evoked Potential Technologists (ABRET) that exhibits nationally recognized best practice standards.It is an expectation that you, as a student in this course, will take responsibility for your learning and use the resources presented to you in this class – including the textbooks, ASET classes, the ABRET website, and journals provided – to aid your understanding of the course. ?Because learning a new field takes patience, we ask that you participate fully in the course throughout each week. This will allow you time to seek out clarification, watch videos, and post and receive answers to your questions.In this program, you may find that you disagree with your instructor or fellow students. ?Disagreement and debate can be a productive part of learning but must be handled in appropriate and productive ways. ?If you disagree with your instructor or a student, express your concern in a respectful manner. This opens the door to communication, in which both parties can hear and discuss each side of the issue. ?A positive attitude and optimistic outlook will go a long way in all situations.Online professional conduct is essential when learning online; therefore, it will be modeled and expected of all in this course. ?The following factors will be taken into consideration when determining professional conduct:Regular class attendanceActive and respectful participationAdherence to the rules of netiquettePromptness in the completion of assigned activitiesRespect for your instructor and classmatesThe purpose of this Statement of Professionalism is to identify the importance of professional conduct in this, and all, online courses. You are expected to abide by the CNM Student Code of Conduct. ?Failure to do so will result in a referral to the Director of Education and/or your Dean (for CNM Faculty) or the Dean of Students (for non-CNM Faculty).Clinical Course CompensationStudents must not complete clinical coursework while in an employee status at a clinical affiliate. Students shall not receive any form of remuneration in exchange for work they perform incident to their clinical education coursework and experience.Electronic Device PolicyStudents are expected to turn their cell phones to silent or on vibrate when entering a clinical site. Cell phones may be used for personal use ONLY during assigned break periods or at lunch, otherwise phones must remain with student’s belongings in the designated storage area. In case of an emergency only, the Clinical Instructor may allow cell phone use. At no time may an electronic device be used to take a picture or video recording of a patient, a patient’s chart, a patient’s radiograph, or anything related to a patient.Student Conduct/Academic Integrity CNM Student Code of Conduct: Policy Netiquette Policy: Netiquette is a set of guidelines used for online courses to keep the communication respectful, productive and healthy. We want to encourage interaction online with your fellow classmates and instructor that is positive, cooperative and supportive. Please follow these guidelines in all your online responses and discussion groups:Follow the golden rule online and remember on the receiving end of your email or post is a real human, a real person with real feelings. Be courteous and respectful about what you say and how you say it in your response or discussion.All course communication should be appropriate, using correct spelling and grammar, respectful tone, and Standard English. Using language that you would use to text or chat isn't appropriate. Never capitalize all letters, this is considered shouting and perceived as aggressive. Flaming is using communication to hurt another with insults and/or name calling creating an intentional hostile environment. Flaming is not appropriate in any situation. Never send a message or response when you’re emotional such as upset or angry. Always wait till you cool down and then always before you send a message re-read your message before sending it to ensure you’re appropriate and communicating effectively.?Always respond to the idea not the person. It's normal to disagree using constructive communication, this will allow you to learn from each other’s experiences and knowledge. Respect one another by honoring their right to their opinion, the right to disagree and responding honestly but thoughtfully. Keep an open mind and share your opinion without dominating a conversation but allowing the opportunity to join the discussion.In order to avoid unintentional plagiarism always cite your work and provide a URL or web link to share material. Be careful with humor, humor can be good and keep the tone light. It can also be perceived as sarcastic, a major opportunity for misinterpretation. Online communication can be frequently misunderstood because of the lack of face-to-face where body language and tone help interpretation. Refer to the Statement of Professionalism for further details.Lastly, if?you’re having problems with another student or the instructor in this course, please call me personally by phone or set up an appointment during my office hours to discuss.?Absences Students are considered absent when they are not in their assigned location at the scheduled date and time, regardless of the reason.Scheduled/Excused Absence: Students are required to notify the Program Director (or designee) by email as early as possible if they expect to be absent. Documentation may be requested to determine whether to excuse an absence. Excused absences will not have a negative effect on the student’s recorded hours. However, the student is responsible for completing any assignments missed during the absence.Unscheduled Absence: Failure to notify the Program Director in advance of an absence will result in the student incurring an unscheduled absence.Excessive Unscheduled Absences:Students who incur three consecutive days of unscheduled absences are considered dismissed from the program.Excessive unscheduled absences that do not occur on consecutive days will result in disciplinary action, up to and including probation or dismissal from the program.Title IXTitle IX of the Education Amendments of 1972 protects people from discrimination based on sex in education programs or activities that receive Federal financial assistance. Any person may report sex discrimination, including sexual harassment, in person, by mail, by telephone, or by electronic mail, using the contact information listed for the Title IX Coordinator, or by any other means that results in the Title IX Coordinator receiving the person’s verbal or written report. Such a report may be made at any time, including during non-business hours.?Title IX Coordinators for CNM are Christopher Cavazos?-?Dean?of Students?(Contact information: CNM Main Campus Student Services Center Room 202B- 525 Buena Vista SE Albuquerque, NM 87106. Email:?ccavazos@cnm.edu?Phone: 505-224-4000 x51240)?and?Juliane Ziter - Executive Director of Human Resources?(Contact information: CNM Main Campus Ted Montoya Building Room 104E- 525 Buena Vista SE Albuquerque, NM 87106. Email:JZiter@cnm.edu Phone: 505-224-4000x51294). For more information regarding Title IX, please visit the CNM Website at?cnm.edu/about/title-ix-policy-and-procedures.TardinessStudents are considered tardy when the Program Director and or Lab instructor starts the lecture and/or activity for the laboratory or clinical setting and the student is not present. Excessive tardiness is defined as late arrival that occurs on three (3) or more occasions during any 30-day calendar period, or on seven (7) or more occasions in any 6-month period. Excessive tardiness will result in disciplinary action, up to and including probation or dismissal from the program.A student may request an approved late arrival, but the student is required to notify the Program Director (or designee) by email as early as possible if they expect to be tardy. Documentation may be requested to determine whether to approve a late arrival.Outside Employment Many students are employed while they are in the ENDT program. It is advised that students not work more than 20 hours in a week and that they are careful to not let their work interfere with their progress in the program.Inclement Weather PolicyPlease follow the CNM HWPS Policy located online at TextbooksDress Code ENDT Program students are required to adhere to the following attire guidelines:Students are expected to be neat and clean in appearance and appear professional at all times in the clinical setting. Uniforms should adhere to CNM ENDT Program, which are wine scrub top and bottoms with a CNM ENDT patch on the left shoulder. Uniform scrubs are worn to be worn during lab and clinical hours. The Uniform includes CNM student ID worn at the collar levelClosed-toe, closed-back shoes and socks in good repair are to be worn by all ENDT students in the clinical setting. For colder weather, only a wine colored lab coat with the ENDT patch on the left should may be worn over the scrub shirt. A long sleeve shirt worn under the uniform scrub top is also permitted. Undershirt hem may not be visible by hanging lower than the scrub top.No artificial nails of any type, including tips, acrylic and gel overlay; nails will be cut short no longer than 1/4” in length. No smoking while in uniform. Students are allowed to change clothes and smoke in designated smoking areas while on CNM campus. Advisory BoardThe CNM ENDT program has an advisory board made up of members of the community and the program including clinical affiliates’ department directors, clinical preceptors, student representatives from each cohort within the program, program director, program clinical coordinator, HWPS dean and associate deans, and other support CNM employees as required. The board meets bi-annually at minimum to get input and feedback from the rmation on National Certification ExamAdditional career information is available from ASET-The Neurodiagnostic Society () and ABRET-The American Board of Registered Electroencephalographic & Evoked Potential Technologists ()Physical Requirements Students must be in good physical and psychological health. May require students to be able to safely lift and/or move a minimum of 50 pounds.Medical ConditionsIn the event that a student has surgery or experiences a significant change in medical status, the student must notify the ENDT Program Director immediately. The director may request that the student have permission from a physician to participate in class, laboratory, or clinical experiences.Appendix I: Supplemental Training Materials-Heal lice (Pediculosis)What are head lice? ? Lice are tiny insects that live on the scalp and crawl through the hair. ? Lice need human blood to live, and die within 24 hours if they cannot feed. ? Lice lay eggs (nits) that cling to the hair close to the scalp. Nits are oval shaped and most often can be seen in the hair behind the ears or near the neck. ? Lice hatch from nits after about 6 days, and can lay more eggs after 10 days. ? Head lice are not a sign of uncleanliness, and they don't spread disease. What are the symptoms? Scalp itching is the most common symptom. How are head lice spread? ? Head lice are usually spread by head-to-head contact. ? Less often, lice can be spread by sharing clothing, combs, brushes, bedding, or sharing storage compartments (like lockers) with someone who has lice. How are head lice treated? ? The American Academy of Pediatrics says the treatment of choice is permethrin 1% creme rinse (such as Nix?). It is available without a prescription. Follow the instructions on the package carefully. ? Permethrin creme rinse kills live lice, but not all of their eggs. You may need to apply it again after 7-10 days to treat the lice that hatch from the surviving eggs. Some experts recommend doing this even if you don't see live lice. ? Many alternative "chemical free" treatments are available, but there is not much scientific information on how well they work. Some might interfere with permethrin treatment. ? No treatment works 100% of the time. If you have questions or if treatment doesn't work, contact your health care provider. What else do I need to do? ? Combing out nits after treatment with permethrin or other lice-killing medications is not necessary to prevent spreading lice. ? Some people do so that others won't mistake them for having live lice. ? Check everyone in your household for head lice. Treat those who share a bed with the person with infestation, and those with live lice or nits close to the scalp. ? Clean hair items and bedding used by infested persons. Washing, soaking, or drying items at temperatures greater than 130? F will kill stray lice or nits. ? Don't spend a lot of time housecleaning, as lice are spread by head-to-head contact. Focus on items, clothing, furniture, or carpeting that have been in contact with the head of the person with infestation in the 24 to 48 hours before treatment. Use a vacuum for carpeting, car seats, and other fabrics or fabric covered items. Don't use chemicals or insect sprays. ? Human head lice don't feed on pets, so pets do not need to be treated. What about school? ? No child should be excluded from school or allowed to miss school because of head lice. ? Children with nits only should be allowed to return to school. Additional information ? Ask your child care program or school if you have questions about their head lice policy. ? Visit the Centers for Disease Control and Prevention website: parasites/lice/headNeurodiagnostic Technology Program Handbook – 2017-18 Page 15 HEAD LICE INFORMATION FROM THE ASET CURRICULUM The link above contains information on the recognition of head lice and treatment options. Unfortunately since END technologists routinely handle the patient's hair and our electrodes rest on the patient's scalp, we will occasionally discover the presence of head lice on our patients. It is very important to remember that lice are insects and anyone, even those with the very best of personal hygiene can pick up head lice. It is most common in school age children and in recent years lice have become immune to the treatments that have been used for years. A well-equipped END lab will be prepared for such an incident. If the patient is an inpatient, the nursing staff should be alerted. Special care should be taken to carefully clean all electrodes and surfaces of the equipment so as not to spread the insects to the next patient. If the patient is an outpatient you may want to establish a policy to cancel the appointment and reschedule after the lice have been eliminated. An information sheet on the treatment of lice is very helpful and should be provided to the patient at this time along with recommendations for eliminating the lice from not only the patient's hair, but bedding, clothing and carpeting within the home. The information sheet should encourage the patient or parents of the patient to not only treat the patient's hair, but to spray bedding and then wash clothing, bedding and pillows in hot water. Combs and brushes should be washed in hot water. A child's car seat cover, towels, and stuffed animals should be washed. The best way to eliminate lice from a home is to assume that the entire family should be treated and that the house should be treated as well. Also, prepare the patient or parents for the likelihood that there will be another outbreak in a week or so requiring an additional treatment. Telling a patient or parent of a patient about the presence of head lice is a delicate matter. First of all, do not over react. It is only a bug. It is easy to pick up head lice and parent's should be reassured that there is no shame in it. If this is the first time you have seen it as an END technologist, rest assured that it will not be the last time you will see it. It is not a sign of lack of personal hygiene. As a matter of fact, lice prefer clean hair. It merely is an insect which is easily transferred from one person to another. Some of the ways that lice can be transmitted are through the sharing of combs and brushes, sharing ball caps on the playground, and little girls playing dress up or beauty shop. It only takes brushing up against someone who is infested and it is very easily passed to an unsuspecting person. While it is not a shameful condition, though it is often perceived as such, it is something that should be treated as soon as possible to prevent spreading. After treatment, nits should be removed with a nit comb under a strong light. This process may take a long time but is the best way to prepare the child for re-entry to school and is the only way to make sure that the lice have been eliminated. Many parents will deal with this at some point during child raising and your attitude and reassurance will make it less traumatic for the child and parent or patient. There are several treatment options which are detailed in the following website. The treatments may kill all the lice and some of the eggs but a repeat treatment in 10 days is usually needed. It is usually the policy that children should have no nits before they can return to school. Your lab should have a policy on head lice. Some patients may need to have their EEG completed and the lab closed down briefly for spraying after the test is complete. A surgical gown, gloves and surgical bonnet worn by the technologist, may help prevent spread of the lice to the staff. When rescheduling a patient with active head lice, explain that you also have a responsibility to the other patients who have testing scheduled in the lab today and you must go through a cleaning process before you can allow another patient into the lab. If care is not taken, the EEG lab can become a source of infestation for other patients. Most patients will understand this and happily reschedule. This site has fun activities for kids and educational material about head lice. Things to remember: ? Be factual and polite. ? Be supportive and understanding ? Provide helpful information for the elimination of the lice from the patient, home and surroundings. ? Add illustrations and be creative. Regulations that protect us: The Environmental Protection Agency and Occupational Safety and Health Administration set standards for safe environment for employees. It is good to know the areas covered by these regulation that protect us in the workplace. II: Neurodiagostic Technology Program Graduate Competencies The EEG technologist provides a safe recording environment by: ? verifying identity of the patient ? disinfecting electrodes after each procedure or using disposable products ? following standard precautions for infection control per facility policy and procedures ? attending to patient needs as established by facility policy and procedures ? recognizing/responding to life-threatening situations ? being certified to perform cardiopulmonary resuscitation ? following facility policy and procedures for sedation ? complying with facility policy and procedures for emergency and disaster situations ? complying with hazardous material handling procedures ? maintaining instrument/equipment in good working order ? taking appropriate precautions to ensure electrical safety. The EEG technologist establishes rapport with the patient and the patient’s family by: ? using personal communication skills to achieve patient relaxation/cooperation ? explaining all test procedures including activation procedures ? explaining the electrode application method (paste, collodion, etc.) ? interacting on a level appropriate to patient’s age and cognitive ability ? maintaining respect and patient confidentiality. The EEG technologist evaluates the patient to: ? determine the patient’s mental age, mental state, and comprehension level ? note the patient’s overall physical condition ? determine appropriate method of electrode application ? ascertain the patient’s capacity to cooperate with activation procedures ? determine if hyperventilation/photic stimulation is contraindicated ? accommodate for disabilities or special needs ? determine the need for additional physiological monitors ? document unusual or inappropriate behavior suggestive of seizure or psychogenic non-epileptic event ? determine the possible need for restraints or emergency intervention. The EEG technologist prepares a basic data sheet that includes: ? patient’s information (name, age, ID number, doctor, etc.) ? recording time, date, and technologist’s name or initials ? pertinent patient history and familial medical history ? previous EEG reports ? current medication/sedation and time of last dosage ? time of last meal ? time, date, aura, and circumstances of last seizure or symptoms ? patient’s mental, behavioral, and consciousness states ? diagram of skull defects or anomalies (if any) ? diagram of any modifications in electrode placement. The EEG technologist’s electrode application follows a method that includes: ? ensuring accurate electrode placement according to the International 10–20 System or modified 10–10 System ? adjusting electrode placement for anatomical defects or anomalies ? cleaning the electrode site to reduce skin impedance prior to scalp electrode application ? applying surface electrodes with EEG conductive paste or with collodion and electrolyte ? verifying surface electrode impedances measure below 5,000 Ohms ? verifying when sterile, disposable subdermal needle electrodes are used, impedances measure below 10,000 Ohms ? applying electrodes to record ECG. Section II: Instrumentation The EEG technologist documents the working condition of a digital EEG instrument by: ? calibrating system amplifiers ? verifying standard filter settings? verifying sensitivity settings ? inputing a biological (bio-cal) signal to all channels ? observing the first 30 seconds of the recording from the primary system-reference montage when instrumental and biological calibration cannot be performed ? correcting or reporting deviations per facility policy and procedure. The EEG technologist applies the principles of electronics and mathematics to recording by: ? knowing how differential amplifiers work ? computing voltage and frequency of waveforms ? calculating the duration of waveforms ? understanding the polarity of waveforms ? understanding impedance ? understanding analog to digital conversion. The EEG technologist knows how digital waveforms are affected by: ? 60 hertz filter ? filter settings ? digital filters ? sensitivity settings ? referential and bipolar montages ? electrodes type and electrode material composition ? malfunctioning equipment ? printer conversion of data. Section III: Recording Principles The EEG technologist obtains a standard EEG that includes: ? a minimum of 20 minutes of technically acceptable recording ? eye opening and closing to check effects of stimuli on EEG ? hyperventilation for a minimum of 3 minutes ? photic stimulation at frequencies appropriate for history and reactivity ? minimum recording of one minute post hyperventilation/photic stimulation ? mental stimulation/assessment procedures ? periodic checks of electrode impedance ? natural drowsiness and sleep, if possible ? notations of montage, filters, display speed, and sensitivity setting changes ? notes of observed behavior, clinical seizure manifestations, etc. ? minimum recording of 2 minutes post any questionable event. The EEG technologist customizes the recording procedure by: ? evaluating reason for referral, history, and observed waveforms ? utilizing techniques to bring out or enhance clinical symptoms ? selecting montages appropriate for abnormalities seen and/or expected ? selecting appropriate instrument settings, i.e., filters, sensitivity, timebase ? encouraging drowsiness and sleep ? applying additional electrodes and adjusting montage, if needed, to localize abnormal activity ? recording respiration, if appropriate ? recording ECG rhythms.The EEG technologist differentiates artifacts from cerebral waveforms by: ? recognizing possible artifactual waveforms ? documenting (on the recording) patient movements ? applying electrodes to record eye movements ? replacing electrodes exhibiting questionable activity or contact ? troubleshooting for possible electrical interference. The EEG technologist: ? reports critical tests results* to the interpreting physician and supervisor and documents this communication according to facility policy and procedures ? documents sedation used, dosage, and effects (if applicable) ? reviews EEG for appropriate documentation or amplifier settings and montage changes ? removes electrode paste/collodion/adhesive from the patient’s scalp and hair. Section IV: Knowledge Base Statements The EEG technologist understands (has a working knowledge of): ? medication effects on the EEG background and waveforms ? medical terminology and accepted abbreviations ? signs, symptoms, and EEG correlates for adult neurological disorders ? signs, symptoms, and EEG correlates for pediatric neurological disorders ? seizure manifestations, classifications, and EEG correlates ? psychiatric and psychological disorders and EEG correlates. The EEG technologist understands and follows technical criteria for ? recording electrocerebral inactivity (brain death) ? recording neonatal EEG ? recording pediatric EEG. The EEG technologist recognizes: ? normal and normal variants awake and asleep patterns for each age range ? abnormal awake and asleep patterns for each age range ? EEG patterns for levels of consciousness ? clinical and nonconvulsive seizure patterns. The EEG technologist possesses the knowledge base necessary to correlate patient history and clinical symptoms in order to determine the appropriate electrode application and recording parameters in the following disease processes: ? seizure classification ? stroke ? trauma ? encephalopathy ? altered consciousness. The EEG technologist maintains and improves knowledge and skills by: ? reviewing EEG records with the electroencephalographer on a regular basis ? reading journal articles ? studying textbooks related to the field ? attending continuing education courses in clinical neurophysiology ? completing online EEG courses ? participating in quality assurance/improvement reviews ? participating in professional organizations for neurodiagnostics ? achieving EEG certification and meeting recertification requirements. * Critical test results – any values/interpretations where delays in reporting may result in serious adverse outcomes for patients. MA Coalition for Prevention of Medical Errors; document/CTRPractices.pdf -- Approved by ASET Board of Trustees March 2011 ? Copyright 2011 by the American Society of Electroneurodiagnostic Technologists, Inc. ................
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