POLICY - ASET



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Sleep Deprived Electroencephalography (EEG) Procedure

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Content Applies To

• Mayo Clinic Health System in Mankato

Scope

Neurophysiology Technologists who have received appropriate training and have demonstrated competency in performing and understanding EEGs

Purpose

To obtain high quality, accurate brain wave recordings

Procedure

Equipment

EEG machine

Photic Stimulator

Reclining chair

Disposable scalp electrodes

Internal impedance meter

ECG monitor

Supplies: tape measure, marking pencil; skin preparation lotion; electrode cream; conductive gel; electrode paste; Sani-wipes disinfectant cloths; disposable gloves

Patient Preparation

1. Identify the correct patient using two patient identifiers, room patient and explain test procedure. Discuss patient’s symptoms and obtain pertinent medical history, including current medications.

2. Prepare patient by measuring and marking patient’s head using the 10/20 International System. Apply surface scalp electrodes with skin preparation lotion and electrode adhesive or electrode paste. Attempt to lower impedance to below 5 K Ohms, impedances must be balanced.

3. Make patient comfortable in chair; add ECG monitor.

4. Perform recording, per department and ASET guidelines with additional montages and activation procedures as indicated by patient’s history. Make thorough notation of patient status, procedure details and any other pertinent information for interpreting neurologist. If study shows frequent epileptiform or other worrisome discharges please page interpreting neurologist immediately prior to ending study or removing any electrodes.

5. Photic stimulation (PS) should be performed at varying frequencies, while checking for reactivity of the EEG recording and/or clinical symptoms of the patient. Photic stimulation cannot be performed if the patient has congenital blindness. Unless ordered by the physician, photic stimulation is contraindicated when a patient has a known seizure disorder activated by photic stimulation.

6. Hyperventilation (HV) should be performed for a minimum of three minutes, with at least one minute recorded after HV has ended. Hyperventilation must be performed for 5 minutes in children under the age of 16. Notation of the patient’s level of cooperation should be noted as should any and all symptoms. Hyperventilation should be performed routinely unless medical or other justifiable reasons contradict it. Contraindications include: pregnancy of any duration, moderate to severe asthma, any COPD or lung cancer, blood clots, moderate to severe cardiac disease, use of oxygen routinely, or recent diagnosis of lung disease or illness affecting the lungs.

7. Remove electrodes and paste with warm water.

8. Assist patient with hair grooming, and escort patient to lobby.

9. Dispose of electrodes in trash receptacle. Wipe headbox, headbox strap, and ekg leads in Sani-wipes disinfectant cloths.

10. Clean room and restock supplies.

Documentation

1. Complete history and patient information. Enter technologist’s impression of EEG. Transfer EEG electronically to reader station.

2. Technologist will notify interpreting neurologist per current lab protocol.

3. Enter patient information into electronic and paper EEG log book.

4. Once interpreted by Neurologist, the transcription department types the report into the Diagnostics tab in electronic medical record.

5. EEGs are archived onto DVDs for storage and retained in the lab.

6. Patient information entered into the Neurophysiology department database.

Additional Information

EEGs may be performed on patients with infectious or contagious diseases. Infectious Disease policies will be followed and skin preparation should be minimal. Paste application should be used.

Patient instructions included in reminder phone call should include no caffeine the morning of the test, only four hours of sleep the night before the test, and no sleep after 5 AM the morning of the test. If patient is an infant or young child, parents should be instructed that a small amount of dozing prior to the test will not ruin the test, only about 30 minutes should be allowed, i.e. car ride to hospital. Patient should arrive with clean, dry hair; completely free of hair products and hair accessories.

References

ASET – The Neurodiagnostic Society

American Clinical Neurophysiology Society Guidelines

Search Words

0969PROC-V1, Neurophysiology Lab, Brain wave test, neurophysiology test, neurodiagnostics, seizure test, sleep deprived EEG

|Document Title: |Sleep Deprived Electroencephalography (EEG) Procedure |

|Document ID Number: |0969PROC-V1 |

|Author: |Petra N. Davidson R. EEG/EP T. |

| |Danielle Hellekson R. NCS T |

| |Jenne Tunnell, AuD. |

|Person to contact if there are questions or concerns |Petra N. Davidson, R. EEG T. |

|regarding this document: | |

|Contributors - Content developed and approved by the |Mayo Rochester ND Laboratory |

|following persons or committees: |ASET |

|Southwest Minnesota Region Senior Leadership Team |Mark Fratzke |

|Signature | |

|Facility Administration and / or Department Director |Dr. Reeves |

|Approval / Signature | |

|Date Document approved by Southwest Minnesota Region |12/17/2013 |

|Policy and Procedure Committee: | |

|Date Document Effective: |12/9/2014 |

|Next Review Date: |12/9/2015 |

|Date Document Taken out of Service: | |

|Revision History |12/9/2014: Updated |

| |12/9/2013: Updated |

| |10/1/2012: New format and Document ID |

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Document ID: 0969PROC-V1

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