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All Guidelines


OSET: Digital Recording- Vertical Resolution: 12 or 16 bits to avoid blocking paroxysmal activity.
OSET: Digital Recording- Horizontal Resolution: 3x the highest frequency is recommended... or at least 2x (256-400) is preferred.
OSET: Digital Recording- Disk Space: 256 x1 gigibite hard drive storage. Also a sampling rate of 200 Hz.
OSET: Digital Recording- Screen: 17" 100 pixels per second, 2 pixels per mm and 1280 x 1024 resolution.
OSET: Digital Recording- Sampling Rate: 200 Hz (Nyquist Criteria)
OSET: Digital Recording- Channel Minimum: 25, preferably 32.
OSET: Digital Recording- Filters (Allows for re-filtering later): 0.1-100.
OSET: Digital Recording- Sensitivity: 1-200.
OSET: Digital Recording- Paper Printout: The standard horizontal scaling should present one second as occupying between 25 and 35 millimeters with a minimum resolution of 200 data points per second.
OSET: Digital Recording- Standard Paper Speed: 30mm/sec, which means every 30mm of paper is equal to 1 second. 1 large section on a page, 5 smaller sections. 15 and 60 are also used at times.
What is the minimum number of channels allowed for a recording? 8.
How many leads are minimally required? 21.
How many montages are minimally required? 3.
Which montages are minimally required? LB, TB, and Ref.
ECS #1: How many electrodes must you use minimally? 8 Scalp.
ECS How much of the scalp should you use? Entire. Skip leads.
ECS #3: What should the impedance be minimally? Below 5 ohms.
ECS Which additional leads should be used? Respiratory, EMG, EOG, EKG.
ECS #5: Should you use 60 Hz filter? No, unless absolutely necessary.
ECS #4: What must be completely tested before recording? Entire system integrity.
ECS #2: What should the inter-electrode distance be? 10 cm.
ECS #5: What should the sensitivity be set at? No higher than 2 uV/mm
ECS #7a: What should the HFF be set at? Not below 30 Hz.
ECS #7b: What should the LFF be set at? Not above 1 Hz.
ECS #6: What is the minimum recording time? 30 minutes.
ECS What paper speed should be used? Slow.
ECS What reference is best to use to avoid EKG artifact? Cz.
ECS What is it called when you turn a pt's head and the eyes stay facing straight ahead? Doll's Eyes.
ECS What should you do with the respirator belt if the pt has a vent tube? Wrap it around the tube.
ECS Which extremity should you stimulate? Every One.
ECS What types of stimulation should you use? Stern Rub, Pinch, Nail Bed Press, Visual (PS) w/ EO, Yell Name, Clap.
ECS What do you do after you do a stimulation? Note the record.
ECS What should the temp and bp follow? The 90/90 Rule - Must be above.
ECS How much time needs to lapse before doing a repeat study? 6 Hours.
ECS What is the maximum allowable leakage current? 100 uA.
ECS When should a ground lead not be used because the pt is already grounded? In ICU.
ECS What is the inter-electrode distance in a routine recording? 6 - 6.5 cm.
ECS Best montage: FP2-C4, C4-02, FP1-C3, C3-01, T4-Cz, Cz-T3 + EKG and 1 non-cephalic (ex: hand).
ECS To avoid high susceptibility to artifact, what montage is best? F7-T5, F8-T6, F3-P3, F4-P4, Fz-Pz and 1 non-cephalic (ex: hand).
ECS What sensitivity should you calibrate this record at? 2 uV (the same as recorded).
ECS What is the best insurance against many artifacts, especially in the ICU? Low Impedance.
ECS One of the 2 physicians must be a: Neurologist, neurosurgeon, or intensivist.
ECS For an adult, the minimal time lapse between two examinations for direct, structural cerebral damage (intracerebral hemorrhage, stroke, trauma, etc.) is: 4-6 Hours.
ECS For an adult, the minimal time lapse between two examinations for non-direct, non-structural cerebral damage (hypoxic-ischemic encephalopathy) is: 12 Hours.
ECS Corroboratory or ancillary tests are optional and not required for an adult unless: A portion of the exam cannot be completed, is altered by a neuro-depressant drug, or the etiology is not certain.
ECS Age statistics are adjusted for prematurity, which is less than: 38 weeks.
ECS Age-specific requirements for confirmatory - 7 days - 18 years: Brain perfusion assessment or 2 EEGs.
ECS Age-specific requirements for exam interval - 7-60 days: 48 hours.
ECS Age-specific requirements for exam interval - 61 days - 1 year: 24 hours.
ECS Age-specific requirements for exam interval - 1-18 years: 12-24 hours.
How much can you move for an alternative montage of the same class? 2-3 to the right.
Is is better to use how many electrodes? The more, the better.
How many montages do you need for an 16 & 18 channel recording? LB: 1, TB: 1, R: 1
How many montages do you need for an 8 & 10 channel recording? LB: 2, TB: 3, R: 2
Two pieces equipment that are required for proper EEG recording: Grounding and PS.
When is it acceptable to use a 'Modified' or 'Estimated' 10/20 system? Never.
Impedance should not exceed... 5 Kohms or 5,000 Ohms.
What should a paper recording have written on the record? Pt name, age, dos, ID #, tech initials.
What montage type should be selected for square wave or bio-cal to show alpha and beta range, as well as eye movements in the delta range? Anterior-posterior (fronto-occipital).
What type of pts sometimes need a slower paper speed? Newborns.
Is sleep or awake activity more important to record in a routine recording? Awake.
What type of pts should you use additional stimuli (somatosensory, auditory, etc.)? Comatose or Stuporous.
OSET: Digital Recording- Amplifiers: 2 reference inputs are needed. One for system reference at input 2 and one to prevent data loss. 25 electrodes total; 21 scalp, ground, system reference, and 2 extra are requited. 9 additional to equal 32 is recommended.
OSET: Digital Recording- Amplitude (So the amplifiers will not saturate but will allow the full range of activity): A recording dynamic range of ±2 mV is recommended.
OSET: Digital Recording- Calibration: A standard microvolt input is applied to each amplifier.
OSET: Digital Recording- Pt Information: DOS, DOB, place of test, last sz, state of behavior, meds, relevant medical hx.
OSET: Digital Recording- Annotations & Comments: A digital system should have a capacity for over 30 programmed comments, & free text comments. Ability to insert comments after recording should also be a part of the system. Date, time of day, and elapsed time should be indicated on every screen.
OSET: Digital Recording- Activation Procedures: Should provide for HV and post HV comments, as well as a timer. Manual and programmable PS protocols should be included with the system along with a strobe indicator on the recording. Available stimulation frequencies should range from 0.5 to 30 Hz.
OSET: Digital Recording- Online Record Review Digital system should include the ability to review earlier section while on real-time acquisition. Allows the tech opportunity to review paroxysmal events and change the display montage and filter settings while continuing to acquire data.
OSET: Digital Recording- Simultaneous Display The ability to simultaneously compare two segments from within the same recording or different recording is desirable.
OSET: Digital Recording- Views as Recorded Allows playback of the EEG recording with the same montages, filter settings, and sensitivity settings that were used by the technologist during the original recording.
OSET: Digital Recording- Equipment Maintenance Digital have the same routine inspection as analog equipment. Includes ground leakage checks, cord resistance measurements, and thorough cleanings, routine computer maintenance including re-seating of all connections, and a disk integrity check.
OSET: Digital Recording- Storage/Retrieval All files must be transferred off the recording instrument and saved onto an external disk. Compressed data is desirable because three times the number of studies can be stored. A LAN between the recording and reading station is recommended.
OSET: Digital Recording- Universal Data Interpretation Provides opportunity to exchange data between systems of different manufacturers. It is a desirable feature especially between dissimilar systems or even different locations. This is currently difficult with some systems due to differences in software.
Infection Control Transmission- What is the most neurological condition to use these guidelines for in EEG? Creutzfeldt-Jakob and variants.
Infection Control Transmission- Goal: Emphasis on interrupting the spread of infection at the point of transmission between source and host.
Infection Control Transmission- Source: Reservoirs of infectious organisms. Organisms may be bacterial, viral, fungal, or parasitic, but most commonly bacterial or viral. People provide the source for the majority of infectious organisms; however, inanimate objects may also act as reservoirs.
Infection Control Transmission- Hosts: Sites for new infection; needs an opening or gate for an infectious organism to enter.
Infection Control Transmission- Modes of Transmission: Directly, from source to host; or indirectly, from source, to inanimate object, to host. There are five main routes of transmission; contact, droplet, airborne, common vehicle, and vector-borne.
Infection Control Transmission- Contact Transmission: One person to another person.
Infection Control Transmission- Droplet Transmission: Primarily through coughing, sneezing, talking, or during certain procedures such as suctioning and bronchoscopy.
Infection Control Transmission- Airborne Transmission: Dissemination of particles through the air or dust. The particles remain suspended in the air for long periods of time.
Infection Control Transmission- Common vehicle Transmission: Transmitted by items such as food, water, medications, and equipment.
Infection Control Transmission- Vectorhorne Transmission: Occurs through animals and insects such as rats and mosquitoes.
Infection Control Transmission- Two Isolation Categories: Standard Precautions and Transmission-Based Precautions.
Infection Control Transmission- Standard Precautions: Assume that every person is potentially infected or colonized with an organism that could be transmitted.
Infection Control Transmission- Transmission-Based Precautions: Provide supplemental practices for airborne, droplet, and contact infections. They are used in conjunction with Standard Precautions and for specific patients or conditions that are highly transmissible or significant.
Infection Control Transmission- When are Standard Precautions used? Used for all patients in all healthcare settings and apply to blood; all body fluids, secretions, and excretions except sweat; non-intact skin; and mucous membranes.
Infection Control Transmission- Isolation Precautions: 1) Respiratory hygiene/cough etiquette, 2) Safe injection practices, and 3) Use of masks for insertion of catheters or injection of material into the spinal or epidural spaces via lumbar puncture procedures.
Infection Control Transmission- Hand Hygiene: Plain or antiseptic-containing soap and water. If no visible soiling of the hands is seen, alcohol-based products are preferred over plain or antiseptic-containing soap and water due to their superior microbiological activity.
Infection Control Transmission- Hand Hygiene for Clostridium Difficile: Soap and water, rather than alcohol-based products, for mechanical removal of spores from hands is recommended.
Infection Control Transmission- When should you be sure to use good hand hygiene? After touching blood, body fluids, secretions, excretions, and contaminated items, (if gloves are worn or not), b/t pts to avoid transfer to other pts or items and different procedures on the same pt to prevent cross-contamination of different sites.
Infection Control Transmission- Gloves: When touching blood, body fluids, secretions, excretions, and contaminated items. Change before touching mucous membranes and non-intact skin, b/t procedures on the same pt after contact with other material, before touching computer or other equipment.
Infection Control Transmission- Mask, Eye Protection, Face Shield: To protect mucous membranes of the eyes, nose, and mouth during procedures and patient care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, and excretions, during sterile procedures, and on coughing patients.
Infection Control Transmission- Gown: To protect skin and to prevent soiling of clothing during procedures and patient care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.
Infection Control Transmission- Patient Care Equipment: Soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to the patients and environments.
Infection Control Transmission- Environmental Control: Ensure there are adequate procedures for the routine care, cleaning, and disinfection of environmental surfaces, beds, bed rails, bedside equipment, and other frequently touched surfaces.
Infection Control Transmission- Linen: Soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures and contamination of clothing, and that avoids transfer of microorganisms to other patients and environments.
Infection Control Transmission- Occupational Health and Bloodborne Pathogens: Prevent injuries when using needles, scalpels, other sharp instruments, when cleaning, and when disposing of. Never recap used needles or otherwise manipulate them using both hands or any other technique that points a needle toward the body.
Infection Control Transmission- Patient Placement: Use a single patient room for patients who contaminate the environment or who cannot be expected to assist in maintaining appropriate hygiene or environmental control.
Infection Control Transmission- Airborne Precautions: Used in addition to Standard Precautions for pts known or suspected to be infected with airborne droplets. Place the pt in an airborne infection isolation room that has monitored negative air pressure, 6 to 12 air exchanges per hour.
Infection Control Transmission- Droplet Precautions: Used in addition to Standard Precautions for pts known or suspected to be infected with microorganisms transmitted by large droplets during coughing, sneezing, talking, or procedures such as suctioning, cough induction by chest physiotherapy, and CPR.
Infection Control Transmission- What are some examples of Airborne illnesses? Measles, varicella, and tuberculosis.
Infection Control Transmission- What are some examples of droplet precaution illnesses? Influenza, diphtheria, mumps, and rubella.
Infection Control Transmission- Contact Illness Definition: Used in addition to Standard Precautions for pts known or suspected to be infected with microorganisms transmitted by direct (pt) and indirect contact (surfaces). or patient care items in the patient's environment (indirect contract).
Infection Control Transmission- Contact Precautions: Use a single patient room or place the patient in a room with a patient who has active infection with the same microorganism but no other infections. Wear a gown and gloves when entering the room.
Infection Control Transmission- What are some examples of Contact Illnesses? Herpes simplex virus, impetigo, lice, and scabies.
OSHA- What does this stand for? Occupational Safety and Health Administration's.
OSET- What does this stand for? Organisation of Societies for Electrophysiological Technology.
OSHA- Bloodborne Pathogens Final Rule: Required healthcare workers to follow specific practices such as wearing gowns and protective apparel under specified circumstances to reduce the risk of exposure to bloodborne pathogens.
OSHA- Needlestick Safety and Prevention Act: The Final Rule was revised in 2001 to conform to this.
OSHA- Exposure Control Plans: The 2001 Final Rule revision reflects how employers implement new developments in control technology; requires employers to get input from employees involved in pt care, and requires employers to maintain a log of injuries from contaminated sharps.
OSHA- What are some of the bloodborne pathogens? Human immunodeficiency virus (HIV), hepatitis B, and hepatitis C.
OSHA- Infectious Waste Definition: Solid waste or mass that may contain pathogens and, if contact with a susceptible host occurs, could result in transmission of an infectious disease.
OSHA- Infectious Waste Examples: Liquid or semi liquid blood or infectious materials, Contaminated items that would release infectious materials, Items that are caked with dried blood or potentially infectious materials, Contaminated sharps, Pathological and microbial wastes.
OSHA- Disposal: Infectious waste must be handled separately from usual trash and treated prior to final disposal.
OSHA- Hand Hygiene: The single most important means of preventing the spread of infection. Wearing gloves does not replace the need for this.
OSHA- Proper Hand Hygiene Technique for alcohol-based hand rub: Apply the product to the palm of one hand and rub hands together, covering all surfaces of the hands and fingers, until the hands are dry.
OSHA- Proper Hand Hygiene Technique for washing hands with soap and water: Wet hands first, apply product to the hands and rub together for at least 15 s. Rinse, dry thoroughly with a disposable towel. Use the towel to turn off the faucet. Avoid using hot water because repeated exposure may increase dermatitis.
OSHA- Handwashing Facilities: Must be provided and when not feasible, the employer must provide either an appropriate antiseptic hand cleanser in conjunction with clean cloth/paper towels or antiseptic towelettes.
OSHA- Artificial Fingernails: Recommends not be to be worn by those who have contact with high-risk patients (e.g., pts in ICUs, ORs) due to confirmed association with outbreaks of gram-negative bacillus and candidal infections. Settings have banned this for all healthcare personnel.
OSHA- Cleaning: The removal of all visible dust, soil, and any other foreign material. Antiseptic soaps should not be used to clean inanimate objects. Gloves are recommended. Spot clean walls if splashes occur. Clean floors by wet mopping, wet or dry vacuuming.
OSHA- Disinfection: Involves the destruction of many or all infectious organisms on inanimate objects.
OSHA- The CDC recognizes four levels of disinfection: Sterilization, high-level disinfection, intermediate-level disinfection, and low-level disinfection.
OSHA- Sterilization: Required to destroy all microorganisms, including bacterial spores. This is necessary for critical items, which are those that enter tissue or vascular space (e.g., needles, implants, and surgical tools) or those through which blood flows.
OSHA- High-Level Disinfection: Appropriate to inactivate the HIV, hepatitis B virus (HBV), and mycobacterium tuberculosis. Used for semi-critical items that contact mucous membranes or non-intact skin, such as respiratory and anesthesia equipment, as well as endoscopes.
OSHA- Intermediate-Level Disinfection: Inactivates M. tuberculosis, vegetative bacteria, most viruses and most fungi, but it does not necessarily kill bacterial spores. Appropriate for some semi-critical items such as hydrotherapy tanks and thermometers.
OSHA- Low-Level Disinfection: Can kill most bacteria, some viruses, and some fungi, but it cannot be relied on to kill resistant microorganisms. Used for noncritical items that have contact with intact skin, which serves as a barrier to most microorganisms.
OSHA- Selection of Disinfectants: The selection of disinfectants involves determination of the level of disinfection required, the impact of the disinfection process on the instruments or devices, the cost of the disinfection method or product, and occupational health or safety risks.
OSHA- Factors Affecting Disinfection: In order for disinfection to be effective, you need to closely follow product or procedure recommendations for proper use. Ex: Some products require wet contact for a certain period of time to achieve the desired level of disinfection.
OSHA- Determining Appropriate Disinfectant: Product information tells actions it has against microorganisms. Ex: If it is a sporicide, sterilant, tuberculocide, vimcide, fungicide, and/or disinfectant, you see it's effectiveness. Since bacterial spores are most resistant, it is usually high-level.
OSHA- Disinfectant Exposure: Use product instructions or 20 minutes at room temperature for high level disinfection; at least 10 minutes for intermediate level disinfection.
OSHA- Sodium Hypochlorite (NaOCl)/Bleach: Effective against a broadspectrum of microbes including gram positive negative bacteria as well as viruses. Can be used for high, intermediate, and low-level disinfection, inexpensive, fast acting, and offer low levels of toxicity and irritancy.
OSHA- Sodium Hypochlorite (NaOCl)/Bleach Precautions: A strong oxidizer that discolors and corrodes metals (especially copper, aluminum, brass, stainless steel, chrome,and silver). Do not soak contaminated sharps in sodium hypochlorite or other disinfectants before disposal or reprocessing.
OSHA- Gloves and Protective Barriers: Require personnel to wear gloves during electrode application and removal for all pt contacts, regardless of potential for contact with blood, body fluids, or microorganisms. This universal policy eliminates the need for the tech to make a judgment call.
OSHA- Electrodes and Syringe Tips: Single use, disposable items whenever possible. If reusable, reprocess only if the cost is less than to replace. Manufacturers state in catalogs and on package inserts: "Sterilization of multiple-use products is the sole responsibility of the user."
OSHA- Needle Electrode Recapping: Do not recap needle electrodes unless specific situations warrant. If you must recap, never use two-handed techniques. An effective method is placing needle cap into a piece of stiff foam attached to a nearby instrument. The foam holds the cap in place.
OSHA- Needle Electrodes: Do not allow needle electrodes to dangle from headboxes or placed on the bedside or tables. A designated puncture resistant container or tray should be used to collect and transport reusable needle electrodes. Have contaminated sharps container available.
OSHA- Electrolyte Products: Skin preparation agents, collodion, and electrolyte paste and gels are usually sold in multi-dose containers. To decrease the risk of cross-contamination, small amt should go into single use container.
OSHA- Syringe: May be used to insert the electrolyte paste or gel via a blunt tip. The syringe is a single use, disposable item and should be discarded after its use. Do not change only the tip and reuse the syringe with the electrolyte paste or gel on another patient.
OSHA- Surface Electrodes: Due to abrading techniques, whether a skin prep or blunted syringe tip, there is the potential to break the skin. Preferred disinfection is to use a product that provides intermediate- to high-level disinfection and use it routinely.
OSHA- Marking Pencils, Tape Measures, Electrode Wires, Toys, Pulse Oximeter Probes, etc.: Wipe with a low-level disinfectant after each use. Allow the items to air dry.
OSHA- Environment: Make sure each pt has clean linen. Any item that comes into contact with the pt or becomes soiled needs to be changed before use with the next pt. Computer keyboards must be disinfected daily, with Quatemary ammonium, which will not damage keys.
OSHA- Blood and Body Fluid Spills: Clean as quickly as possible. Wear gloves and use paper towel. Follow rules for disposal of infectious waste. Use appropriate disinfectant (use of an intermediate-level chemical germicides) and discard paper towels and gloves in the trash.
OSHA- Disinfection & Acetone: Acetone is not a cleaning or disinfecting agent. Sufficient quantities of frequently used equipment should be available to allow appropriate time for disinfecting b/t uses. Classify items as critical, semi-critical, or non-critical.
OSHA- Critical EEG Items: Needle electrodes (subdermal and EMG), Indwelling depth electrodes, EEG (subdural and epidural) electrodes, Spenoidal electrodes, Tympanic electrodes, Urethral electrodes, and other items that enter tissue or vascular spaces or that blood flows through.
OSHA- Semi-Critical Items: Surface electrodes, NP electrodes, Electroretinogram (ERG) electrodes, Electrode caps, Nasal/oral thermo couples, CPAP/BPAP masks and tubing (Hobby 2007), Electrodes and all items exposed to non-intact skin or blood and body fluids.
OSHA- Noncritical Items: Surface electrodes (no abrasives), Electrode cap, Tape measures, Calipers, Marking pencils, Hair clips, Combs, Simulator prongs, Temperature probes on the skin, Oximeter, Patient toys, Bed rails, Headbox and cables, Any that contact with intact skin.
OSHA- Recording in the Operating Room: Maintain a relatively sterile environment and follow policies and procedures that reduce the spread of infection to patients.
OSHA- Recording in the Nursery or Neonatal Intensive Care Unit: Newborn infants are at increased risk for development of infection, and premature, low-birth weight infants are at greatest risk. EEG personnel must follow policies and procedures to reduce the spread of infection when recording in this unit.
OSHA- Lice: If in-patient, nursing should be alerted. Care should be taken to carefully clean all electrodes of END equipment as not to spread insects. If the patient is an outpatient, establish a policy to cancel the appt and reschedule after eliminated.
OSHA- CJD: Transmitted via corneal transplants, cadaveric human growth hormones, cadaveric dura mater grafts, cerebrospinal fluid, human pituitary extracts, and inadequately sterilized EEG electrodes and neuro surgical equipment. Not known if transmitted by blood.
OSHA- Inactivation of CJD: This prion is resistant to sterilization and disinfection by most of the physical and chemical methods in common use. Single use, disposable invasive items are strongly recommended. When reusable must be used, strictest form of decontamination tolerated.
OSHA- MSI: The Microbial Safety Index. Used to identify the probability that an item is contaminated.
OSHA- Sterilization Definition: Act or process, physical or chemical that destroys all forms of life, especially micro-organisms and spores.
OSHA- Spaulding Definition: Applying the principle of Standard Precautions. This method of Decontamination should be sufficient for all situations.
OSHA- Formite Definition: An inanimate object, which in itself is not harmful, but is able to harbor pathogenic micro-organisms and thus may serve as an agent or transmission of infection.
OSHA- Empiric Definition: Temporary precautions.
OSHA- Disinfection Definition: Eliminates nearly all recognized pathogenic micro-organisms, but not necessarily all microbial life (eg bacterial spores) on inanimate objects.
OSHA- Decontamination Definition: A pre-cleaning process to remove all visible signs of organic matter prior to sterilization or disinfection.
OSHA- Virulence Definition: The degree of pathogenicity of a micro-organism. IE: The competence of a micro-organism to produce pathologic effects.
OSHA- Nonviable Definition: The irreversible loss of the ability to propagate.
OSHA- Pasteurization Definition: Disinfection that uses hot water at temperatures below 100 degrees centigrade. It consists of washing, rinsing, and filtered drying. Not sporicidal.
OSHA- Sanitation Definition: Any process that causes a reduction (to safe level) of microbial populations on an inanimate object.
OSHA- Spore Definition: A reproductive cell that usually possesses a thick wall enabling it to withstand unfavorable environmental conditions. Requires prolonged exposure to high temperatures. Sterilization or Sporicide are only decontamination methods that will destroy this.
OSHA- Sterilization Definition: Completely destroys or eliminates all forms of microbial life including bacteria, viruses, spores, and fungi. Necessary when item is penetrating or entering sterile tissue. Achieved by EPA registered sporicide, steam, ethylene oxide, dry heat.
OSHA- Virucide Definition: Process or chemical that kills viruses.
OSHA- What is the difference b/t Cleaning, Disinfecting, and Sterilization? Removal of all visible dust, soil, and any other foreign material vs. Eliminating nearly all recognized pathogenic micro-organisms, but not necessarily all microbial life vs. Completely destroys or eliminates all forms of microbial life.
OSHA- What does EPA stand for? Environmental Protection Agency.
OSHA- What are the 2 methods of sterilization? 1. Heat: Thermal heat (moist heat in steam autoclave) and Dry heat (hot-air oven) 2. Chemical: Ethylene Oxidate (C2H4O) and liquid chemicals.
OSHA- What should employees wash contaminated linens and reusable protective clothing with if professional laundry services are not available? Hot water and household bleach.
Conscious Sedation - Statistics: Sedation was attempted in 18% of EEGs performed during the 4-year period. Ninety-one percent of the EEGs performed with sedation were completed successfully.
Conscious Sedation - Most Frequent Drug: Chloral Hydrate (CH).
Conscious Sedation - Conclusion: Sedation of children who are undergoing EEG examinations is effective and safe. Complications are infrequent.
Conscious Sedation - How do you reduce the need for sedation in children? Adequate preparation and by creating a less-threatening, child-friendly environment.
Conscious Sedation - Purposes: Allows application of recording electrodes to the scalp without causing excessive anxiety and without the need for restraints, it permits recordings with less muscle and movement artifact,and it allows the recording of the drowsy and asleep states.
Conscious Sedation - Which children are at increased risk for complications from sedation? Those who have an underlying problem with apnea or control of secretions or their airway - because pts lose the control of their body that keeps their airway open.
Conscious Sedation - What is JCAHO? The Joint Commission on Accreditation of Healthcare Organizations.
Conscious Sedation - What sedatives have been used in EEG? Chloral Hydrate, Fentanyl, Pentobarbital (Nembutal), Secobarbital (Seconal Sodium), Diazepam (Valium) Midazolam (Versed) and others.
Conscious Sedation - Can an EEG Technologist administer sedation? Only if registered, involved in annual continuing education courses on sedation, and administering oral under the supervision of a licensed physician.
Conscious Sedation - Why is CH the DOC? Safe, low therapeutic doses (80 mg/kg per body weight) and little effect on EEG at sedative levels.
Conscious Sedation - What are the effects of CH at toxic levels? Respiratory depression can occur.
Conscious Sedation - When are sedation deaths most likely to occur? When levels of consciousness or breathing are not being monitored.
Conscious Sedation - What does ASA stand for? American Society of Anesthesiologists.
Conscious Sedation - Why is conscious sedation so dangerous? Response may vary depending on factors such as speed and amount of drug absorption, underlying medical conditions, age of pt, recent sleep deprivation, and individual sensitivity to agents.
Conscious Sedation - What is to be done to prevent highly sensitive pts from dangerous effects? Monitor all pts through entire sedation process.
Conscious Sedation - What are the JCAHO Requirements? One standard of care, Pre-sedation health eval, Informed consent, Monitors and safety equipment, Standard forms and documentation, A person not performing test to monitor, Recovery protocols, Means to measure recovery.
Conscious Sedation - What are some examples of monitoring a sedated pt? BP, O2/Pulse monitor, Respiratory rate documented every 5 minutes for conscious and deep sedated pts.
Conscious Sedation - BP: No. A cuff may awaken the pt. Only take when awakening pt after procedure. CH is not known to effect this.
Conscious Sedation - What is the most sensitive monitor of brain O2 levels? EEG.
Conscious Sedation - What is the most accurate measurement in monitoring a pt during sedation? O2 saturation levels, as long as no supplemental O2 is being given to the pt.
Conscious Sedation - Pre-Sedation Health Evaluation: Should include hx and exam from past 30 days. An exam will be performed before the sedation by a physician, which should include age, weight, hx, allergies including drug, drug use, dosage, time route, and site of med admin.
Conscious Sedation - Informed Consent: Must follow local requirements of state and institution and provide a 24 h phone number explain precautions and activity limitations. May or may not require signature. Drug info is available at pharmacy.
Conscious Sedation - Standard Monitors and Safety Equipment: Monitoring of respiratory is a must in pediatric sedation since this is the most common complication. Document tests of compentcy is a must.
Conscious Sedation - Documentation and Forms: Everyone in the facility must use the same standardized forms. How often a particular monitor is being monitored. Monitors include pulse, hr, bp, resp rate and EKG if not in EEG, conscious level and possible additional comments every 5-15 minutes.
Conscious Sedation - Second Person Required: AAP (American Academy of Pediatrics) and JCAHO state that someone not performing the test is required to watch all monitors throughout the procedure.
Conscious Sedation - Recovery and Discharge: Cardiovascular function and airway patancy stable, Pt is easily arousable and protective reflexes in tact, Pt can talk when appropriate, Pt can sit unaided (age app), If normally incapable of above, normal response level should be very close to normal.
Conscious Sedation - Performance Improvement: JCAHO requires some form of evaluation of improvement plan after sedation. This may be set facility-wide or you may develop your own.
ACNS - What is the ACNS? The American Clinical Neurophysiology Society. A professional association dedicated to fostering excellence in clinical neurophysiology and understanding of CNS & PNS function in health and disease through education, research, discussion forum.
ACNS - Guideline 1: Minimum Technical Requirements for Performing Clinical Electroencephalography.
ACNS - Guideline 2: Minimum Technical Standards for Pediatric Electroencephalography. Appropriate reduction of sensitivity (to 10 µV/mm or even 15 µV/mm) should be used. Passive eye closure (by placing hand over the pt’s eyes), allow extra time for common mvt artifact.
ACNS - Guideline 3: Minimum Technical Standards for EEG Recording in Suspected Cerebral Death. (ECI) or (ECS). Since, prior to the recording, one does not know whether an ECI record will be obtained, use a full set electrodes in init'l examination.
ACNS - Guideline 4: Standards of Practice in Clinical Electroencephalography. Minimal electroencephalographer qualifications (physician), EEG tech (not less than 6 months of supervised clinical experience), lab director has responsibility for overall policies.
ACNS - Guideline 5: Guidelines for Standard Electrode Position Nomenclature. 10-20 modified combinatorial 10-10 system;.
ACNS - Guideline 6: A proposal for standard montages to be used in clinical EEG.
ACNS - Guideline 7: Guidelines for writing EEG reports. Provide minimum of information about the pt, (age, sex, etc.), test ID #, then 3 principal parts: (A) Introduction, (B) Description of the record, and (C) Interpretation, including (a) impression (b) correlation.
ACNS - Guideline 8: Guidelines for recording clinical EEG on digital media. (See OSET). Commercial devices may be unreadable within a few years of storage. Newly emerging standards may make this less of a problem.
ACNS - EEG Monitoring in Neonates: For selected, long-term monitoring of high risk neonates of post-menstrual age less than 48 weeks (Since epileptic szs are difficult or accurately identify by visual inspection alone). Sens = 2-15 uV.
ABRET - Code Of Ethics 1: Do everything in his or her power to insure that the current Guidelines of the American Clinical Neurophysiology Society are complied with in the department in which he or she works.
ABRET - Code Of Ethics 2: Preserve human dignity, respect pt’s rights and support the well being of the pt under his or her care. The Registered or Certified person shall avoid discrimination against individuals on the basis of race, creed, religion, sex, age and national origin.
ABRET - Code Of Ethics 3: Appreciate the importance of thoroughness in the performance of duty, compassion with patients and the significance of the tasks he or she perform.
ABRET - Code Of Ethics 4: Preserve the confidentiality of medical and personal information of a patient.
ABRET - Code Of Ethics 5: Strive to remain abreast of current technology and to study and apply scientific advances in his or her specialty. Carry out their professional work in a competent and objective manner.
ABRET - Code Of Ethics 6: Abide by laws related to the profession and to general public health and safety and avoid dishonest, unethical or illegal practices.
ABRET - Code Of Ethics 7: Refuse primary responsibility for interpretation of testing or monitoring of studies for purposes of clinical diagnosis and treatment. Individuals who are licensed or otherwise authorized by practice standards to provide interpretation are excluded.
ABRET - Code Of Ethics 8: Be truthful, forthcoming, and cooperative in their dealings with ABRET.
ABRET - Code Of Ethics 9: Be in continuous compliance with ABRET’s rules (as amended from time to time by ABRET).
ABRET - Code Of Ethics 10: Respect ABRET’s intellectual property rights.
ABRET - Violations to ABRET Code Of Ethics: Maintenance of board certification will require adherence to these and other ABRET rules. Individuals who fail to meet these requirements may have their certification suspended or revoked. ABRET does not guarantee the job performance of any individual.
ABRET - Reporting Requirements: Techs convicted of a felony must notify ABRET of and shall be ineligible to apply for registration, certification, or renewed registration for a period of three years from the exhaustion of appeals or final release from confinement, whichever is later.
ABRET - Grounds for Disciplinary Action include, but are not limited to: No certification, copying, disruption, fraud, fees, misuse of credentials, misrepresentation, no requested info, no inform of changes, substance abuse, malpractice, no safety, credential dates, felony, continuous compliance.
ABRET - Sanctions: Denial or suspension of eligibility; Denial of certification; Revocation of certification; Non-renewal of certification; Suspension of certification for a specific period of time; Reprimand; Probation; or Other corrective action.
ABRET - Appeal: Candidates or certificants may appeal the decision of the Discipline Committee to ABRET Board of Directors by submitting written statement within 30 days. It is the candidate’s responsibility to initiate this appeal in accordance with ABRET’s policies.
ABRET - Ethics & Disciplinary Committee: Responsible for oversight of the Code of Ethics and Standards of Practice which protect the public. Assesses formal complaints and oversees the disciplinary for ABRET. Has jurisdiction over all ABRET techs, both current and prospective.
ABRET - Summary of the violations that have been reported and decided by Ethics & Disciplinary Committee: Falsification of credentials, Unprofessional behavior, Provided false information on their application, Found guilty of sexual misconduct, Misuse of ABRET trademarks, Reports of cheating.
HIPAA - What does this stand for? Health Insurance Portability and Accountability Act (of 1996).
HIPAA - What does this mean? Protects health insurance coverage for workers and their families when they change or lose their jobs. Provisions also address security and privacy of health data. Standards are meant to improve the nation's health care system.
HIPAA - Who is covered by the Privacy Rule? Applies to health plans, health care clearinghouses, and to any health care provider who transmits health information in electronic form in connection with transactions for which the Secretary of HHS has adopted standards.
HIPAA - Business Associate Defined: A person or organization, other than a member of a covered entity's workforce, that performs functions on behalf of, or provides certain services to, a covered entity that involve the use or disclosure of individually identifiable health info.
HIPAA - Business Associate Contract: When a covered entity uses a contractor or other non-workforce member to perform "business associate" services or activities. The Rule requires that the covered entity include certain protections for the information in a business associate agreement.
HIPAA - Protected Health Information; All "individually identifiable health information." •Pt's past, present or future physical or mental health, •Provision of health care, or •Payments for care that identifies the individual.
HIPAA - De-Identified Health Information: -No restrictions on use or disclosure of de-identified health info. 2 ways to de-identify info: 1) a formal determination by a qualified statistician; or 2) removal of identifiers and relatives, household members, and employers is required.
HIPAA - Principle for Privacy Rule: Define and limit the circumstances in which an individual’s protected heath information may be used or disclosed by covered entities.
HIPAA - Required Disclosures Only: Disclose protected health info in only two situations: (a) to individuals (or their personal representatives) specifically when they request access to it. (b) to HHS when it is undertaking a compliance investigation or review or enforcement action.
HIPAA - Permitted Uses and Disclosures: (1) To the Individual. (2) Treatment, Payment, Health Care Operations for its own treatment, payment, and health care operations activities. Also Public Interest and Benefit Activities for 12 national priority purposes.
HIPAA - Covered entities may use and disclose protected health information without individual authorization as required by law: Public Health, Abuse, Neglect or Domestic Violence, Health Oversight Activities, Judicial and Administrative Proceedings, Law Enforcement Purposes, Decedents for Death, Cadaveric Organ Donation, Research, Threat to Health or Safety, Government Functions.
HIPAA - Authorization: A covered entity must obtain the individual’s written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.
HIPAA - Psychotherapy Notes: A covered entity must obtain an individual’s notes with the following exceptions: training, to defend itself in legal proceedings by individual, for HHS to investigate compliance and marketing.
HIPAA - Minimum Necessary: A covered entity must make reasonable efforts to use, disclose, and request only the minimum amount of protected health information needed to accomplish the intended purpose of the use, disclosure, or request.
HIPAA - Privacy Practices Notice: Each covered entity must provide a notice of its privacy practices. The Privacy Rule requires a notice must describe the ways they may use and disclose protected info and duties to abide by.
HIPAA - Notice Distribution: Not later than the first service encounter by personal delivery, posting the notice at each service delivery site, in emergency treatment situations, as soon as practicable.
HIPAA - Restriction Request: Individuals have the right to request that a covered entity restrict use or disclosure of protected health information for treatment, payment or health care operations, disclosure to persons involved in the individual’s health care.
HIPAA - Confidential Communications Requirements: Must permit individuals to request an alternative means, location, or concealment for receiving communications. The health plan may not question the individual’s statement of endangerment.
HIPAA - What is HHS? United States Department of Health and Human Services.
HIPAA - Special Case - Minors: In most cases, parents are the representatives for minor children. In certain exceptional cases, the parent is not considered the personal representative. In these situations, the Privacy Rule defers to State and other law to determine the rights.
NPSG - What does this mean? National Patient Safety Goals.
NPSG - Goal 1. Improve the accuracy of patient identification. Use at least two patient identifiers when providing care, treatment and services.
NPSG - Goal 2. Improve the effectiveness of communication among caregivers. Report critical results of tests and diagnostic procedures on a timely basis.
NPSG - Goal 3. Improve the safety of using medications. Label all medications, medication containers, and other solutions on and off the sterile field in perioperative and other procedural settings.
NPSG - Goal 7. Reduce the risk of health care–associated infections. Comply with either current Centers for Disease Control and Prevention (CDC) hand-hygiene guidelines or World Health Organization (WHO) hand-hygiene guidelines.
NPSG - 8. Accurately and completely reconcile medications across the continuum of care. *No longer applicable in 2012. Patients are at high risk for harm from adverse drug events when communication about medications is not clear. The chance for communication errors increases whenever individuals involved in a patient’s care change.
NPSG - Goal 9 - Reduce the risk of patient harm resulting from falls. Reduce the risk of falls.
NPSG - Goal 10 - Reduce the risk of influenza and pneumococcal disease in institutionalized older adults. *No longer applicable in 2012. Develop and implement a protocol for administration and documentation for vaccines to manage an outbreaks.
NPSG - Goal 11 - Reduce the risk of surgical fires. *No longer applicable in 2012. Educate staff providers on how to control heat sources.
NPSG - Goal 13 - Encourage the active involvement of patients and their families in the patient’s own care as a patient safety strategy. *No longer applicable in 2012. Define and communicate the means for patients and their families to report concerns about safety, and encourage them to do so.
NPSG - Goal 14 - Prevent health care-associated pressure ulcers (decubitus ulcers). *No longer applicable in 2012. Assess and periodically reassess each patient’s risk for developing a pressure ulcer and take action to address any identified risks.
NPSG - Goal 15: The organization identifies safety risks inherent in its patient population. Identify patients at risk for suicide.
NPSG - Goal 16: Improve recognition and response to changes in a patient’s condition. *No longer applicable in 2012. The organization selects a suitable method that enables health care staff members to directly request additional assistance from a specially trained individual(s) when the patients condition appears to be worsening.
NPSG - Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery. 1. Conduct a pre-procedure verification process. 2. Mark the procedure site. 3. A time-out is performed before the procedure.
NPSG - When was the first set of NPSGs effective? January 1, 2003.
MSDS - What does this mean? Material Safety Data Sheet.
MSDS - What is this for? Required under the U.S. OSHA Hazard Communication Standard. This is a detailed informational document prepared by the manufacturer or importer of a hazardous chemical.
MSDS - Summary of Requirements The name of the chemical (same as on the label), The chemical and common names of the substance, A listing of the ingredients, A statement of the ingredients that are known carcinogens or that present other known hazards, Any specific hazards.
MSDS - First must contain: Identity (As Used on Label and List).
MSDS - Section I: Manufacturer's Name, Emergency Telephone Number, Address, Telephone Number for Information, Date Prepared, Signature of Preparer (optional).
MSDS - Section II: Hazardous Ingredients / Identity Information.
MSDS - Section III: Physical/Chemical Characteristics. Boiling Point, Vapor Pressure (mm Hg), Vapor Density (AIR = 1), Solubility in Water, Specific Gravity (H2O = 1), Melting Point, Evaporation Rate(Butyl Acetate = 1), Appearance and Odor.
MSDS - Section IV: Fire and Explosion Hazard Data. Flash Point (Method Used), Flammable Limits, Extinguishing Media, Special Fire Fighting Procedures, Unusual Fire and Explosion Hazards.
MSDS - Section V: Reactivity Data. Stability, Conditions to Avoid, Incompatibility (Materials to Avoid), Hazardous Decomposition or Byproducts, Hazardous Polymerization.
MSDS - Section VI: Health Hazard Data. Route(s) of Entry, Health Hazards (Acute and Chronic), Carcinogenicity, Signs and Symptoms of Exposure, Medical Conditions Generally Aggravated by Exposure, Emergency and First Aid Procedures.
MSDS - Section VII: Precautions for Safe Handling and Use. Steps to Be Taken in Case Material is Released or Spilled, Waste Disposal Method, Precautions to Be taken in Handling and Storing, Other Precautions.
MSDS - Section VIII: Control Measures. Respiratory Protection (Specify Type), Ventilation, Protective Gloves, Eye Protection, Other Protective Clothing or Equipment, Work/Hygienic Practices.
NPSG - Goals that are no longer applicable: 4, 5, 6, 8, 10, 11, 12, 13, 14, 16.
Allergy & Sensitivity - Latex: May be present in packaging, even if the product itself doesn't contain this. According to the OSHA, the use of powder-free gloves can to reduce the latex proteins into the air, decreasing the likelihood of reactions via the inhalation and dermal routes.
Allergy & Sensitivity - What are some symptoms of a latex allergy? Irritant contact dermatitis and severe reactions divided into Type I & IV hypersensitivity.
Allergy & Sensitivity - Type I Hypersensitivity: Immediate (more serious), by touch. Symptoms: redness, urticaria, itching under the glove. Severe generalized reactions include facial swelling, rhinitis, eye symptoms, scratchy throat, respiratory distress, bronchospasm, and, in rare cases, anaphylaxis.
Allergy & Sensitivity - Type IV Hypersensitivity: Delayed: Symptoms include: redness of the skin, raised rash, blistering, crusting, and horizontal cracks that may extend up the forearm.
Allergy & Sensitivity - Preventing Latex Allergy: Identify patients and caregivers at risk for latex sensitivity, for latex allergy or sensitivity use non-latex gloves, Post a sign that latex precautions are in effect.
Allergy & Sensitivity - Adhesives: The most common allergic reaction to a medical adhesive is a rash classified as contact dermatitis. Latex is a common cause of contact dermatitis, so medical adhesives no longer contain latex but allergy can still occur.
Allergy & Sensitivity - Adhesives & Symptoms: Can resemble a burn. May appear red and irritated with small bumps & itching, mild to severe. Severe: Painful blisters can break causing infection, generally limited to the area of contact.
Allergy & Sensitivity - Adhesives & Tx: Area should then be cleansed with a mild soap and water to remove any residual particles of adhesive. If the reaction is severe, OTC antihistamines and corticosteroid creams may be used for mild itching. If severe blistering, should eval for infection.
Allergy & Sensitivity - Adhesives & Prevention: Use specifically, paper tapes and hypoallergenic tapes. In the event that all types of medical adhesives cause a reaction, then self-adhering gauze should be used with the tape being placed on the gauze and not the skin.
Seizure Precautions - After a Sz 1: Stay with the person until the seizure ends naturally. Offer to call a taxi, friend or relative to help the person get home if he seems confused or unable to get home by himself.
Seizure Precautions - After a Sz 2: When the patient is in a safe position, remove as much excess secretion from the mouth as possible.
Seizure Precautions - After a Sz 3: Use an oral airway only if the patient is unable to maintain his/her own airway and there is no gag reflex (patient will gag on oral airway and vomit, increasing risk of aspiration).
Seizure Precautions - After a Sz 4: Cover the patient to keep him/her warm and protect him/her from the embarrassment of incontinence. Be friendly and reassuring as consciousness returns.
Seizure Precautions - After a Sz 5: Seek help now if needed.
Seizure Precautions - After a Sz 6: Be conscious that the sense of hearing is the first to return. Speak quietly and calmly to the patient.
Seizure Precautions - After a Sz 7: Do not give the patient anything to eat or drink until he/she is fully awake.
Seizure Precautions - After a Sz 8: Anticipate medication orders.
Seizure Precautions - After a Sz 9: Monitor vital signs, including pulse oximetry.
Seizure Precautions - After a Sz 10: Keep the pt low.
Seizure Precautions - After a Sz 11: Continue to observe the patient, including frequent neurological checks.
Seizure Precautions - Post Sz Testing Protocol: 1. Point to the ceiling with both hands, 2. Ask what they are feeling, 3. Ask to remember “purple elephant” 4. Repeat: “I heard him speak on the radio last night.” 5. Show two fingers. 6. Tell me your name. 7. Ask “What did I tell you to remember?”
Updated Seizure Precautions - 1 Keep calm and reassure other people who may be nearby. Provide safety and privacy for the pt. Call for help when possible.
Updated Seizure Precautions - 2 Don't hold the person down or try to stop his movements. If seated when seizure occurs, lower to the floor and place in a side-lying position. Do not try to move the patient to another place.
Updated Seizure Precautions - 3 Time the seizure with your watch.
Updated Seizure Precautions - 4 Clear the area around the person of anything hard or sharp. Never forcefully turn neck or rigid extremity once the seizure starts.
Updated Seizure Precautions - 5 Loosen ties or anything around the neck that may make breathing difficult.
Updated Seizure Precautions - 6 If patient falls to the floor, protect the head with padding, e.g., blanket, pillows. Put something flat and soft, like a folded jacket, under the head.
Updated Seizure Precautions - 7 Turn him or her gently onto one side. This will help keep the airway clear.
Updated Seizure Precautions - 8 Do not try to force mouth open with any hard implement or fingers. It is not true that a person having a seizure can swallow his tongue. Efforts to hold the tongue down can cause injury.
Updated Seizure Precautions - 9 Don't attempt artificial respiration except in the unlikely event that a person does not start breathing again after the seizure stops.
Updated Seizure Precautions - When is an emergency room visit needed? Diabetes, Brain infections, Heat exhaustion, Pregnancy, Poisoning, Hypoglycemia, High fever, Head injury.
Electrical Safety - What is a safe power source? 117 v domestic operating voltage from service line and may range from 105-130 v.
Electrical Safety - How is leakage current controlled? Instruments such as ground wires.
Electrical Safety - What is Stray Capacitance? The most common leakage current and is found in power cords, power supply, or wiring inside a machine. It is increased by extension cords.
Electrical Safety - What is Stray Inductance? Another source of leakage current. AC passing through an inductor creates an electromagnetic field which expands and collapses.
Electrical Safety - The power supply voltage should be what? 100-240 B.
Electrical Safety - The power supply frequency should be what? 50-60 Hz.
Electrical Safety - The Power consumption (not including the computers) should be what? 20 W.
Electrical Safety - The PC must not be situated closer than what from a patient. 1.5 m.
Electrical Safety - Impedance: The instrument provides high quality EEG recording if the resistance is less than 20 kΩ; it is recommended to achieve resistance less than 10 kΩ, and in a case of strong radio interference – less than 5 kΩ.
Electrical Safety - Input Impedance: Not less than 200 MΩ.
Electrical Safety - What is a fault circuit? One that will allow current to pass safely (harmlessly) to the ground.
Electrical Safety - What is a ground loop? Two instruments interconnected by a common ground and another connection between made up of a magnetic radiation in it's vicinity to complete the loop.
Electrical Safety - What is shock? Current that can be harmful or fatal.
Electrical Safety - What is macroshock? A large and perceptible current passing from one external surface to another.
Electrical Safety - What is microshock? A very low current that can sometimes still be lethal.
Electrical Safety - What color is the hot wire? Black.
Electrical Safety - What color is the neutral wire? White.
Electrical Safety - What does the neutral wire do? It returns the current to the transformer.
Electrical Safety - What color is the ground wire? Green.
Electrical Safety - In a 2 wire system, what can happen to the neutral wire? It 'acts' like a ground wire but may still have small voltage relative to building.
Electrical Safety - What happens when you use an extension cord? It can increase the voltage in a neutral wire.
Electrical Safety - What is the greatest danger to a 2 wire system? Accidental short circuiting that can cause severe shock, burn, or even death if ground and case touch at the same time.
Electrical Safety - What does a 3 wire system prevent and how? Accidental short circuiting because voltage returns directly to the ground.
Electrical Safety - What are the leakage current limits? For ground to chassis was 300 microamperes, (300 μA). Depending on the specific medical device, leakage current limits are as low as 10 μA.
Electrical Safety - What helps in not having excessive leakage currents? Ground wires.
Electrical Safety - Where do you find the most leakage current? In power supply or power cords.
Electrical Safety - Where else can you find leakage current? In the wiring of the machine.
Electrical Safety - What is stray inductance? Another source of leakage current. AC passing through an inductor creates an electro-magnetic field, which expands and collapses.
Electrical Safety - What happens when you connect 2 grounds on a pt? It causes a difference in voltage between the two grounds and the current can flow through the pt.
Electrical Safety - What is a ground loop? Two instruments with a common ground that produce magnetic fields that the pt or others will close circuit if connected between.
Electrical Safety - What helps prevent ground loops? Putting outlets in cluster at the same ground points.
Electrical Safety - What is a redundant ground? A separate heavy gauged wire attached to the case of a machine with the other end attached to a drain pipe.
Electrical Safety - What can help with 60 Hz interference? Grounding to the pt's bed.
Electrical Safety - What type of shocks do you get with DC? Shocks that may cause a skin burn.
Electrical Safety - What type of shock do you get with AC? A lethal shock.
Electrical Safety - When is a microshock lethal? When applied to legs and arms or introduced directly into the heart.
Electrical Safety - What are the 3 situations when using electrical instruments that pts are at risk? When involving high risk pts such as neos or O2, when using a single electrical instrument, and using electrical equipment that is not connected to the pt.
Electrical Safety - How can a pt get a shock from electrodes on the scalp? By not using optical isolators to separate the main power circuitry from the patient in the differential amplifiers. The separation prevents the possibility of accidental electric shock.
Electrical Safety - What is the meaning of Ohm's Law? The law related to electricity and states that the current through a conductor between two points is directly proportional to the potential difference across the two points. Introducing the constant of proportionality, the resistance.
Electrical Safety - What is the formula for Ohm's Law? I=V/R where I is the current through the conductor in units of amperes, V is the potential difference measured across the conductor in units of volts, and R is the resistance of the conductor in units of ohms. R is independent of the current.
Pt Hx - What impression are you supposed to give? That you are simply gathering information.
Pt Hx - What are the generic questions you should ask for a HA pt? What is your name? How old are you? Are you R or L handed? What medications do you take? Have you had an EEG before? When?
Pt Hx - What question is the 'heart' of hx taking? Why does your doctor want you to have this test? Get precise answers.
Pt Hx - What question will give you the 'Chief Complaint?' The question that is the 'heart' of hx taking.
Pt Hx - What questions should you ask to learn about the Chief Complaint? Is it happening now? How often does it occur? Can you describe them? Where are they? What makes them better or worse? Any accompanying symptoms? Visual disturbances? Nausea or vomiting? Unusual sensations? Fever?
Pt Hx - Should a pt have a headache during a recording? Why or why not? No because it could cause technical problems.
Pt Hx - What questions should you ask if the chief complaint is stroke? When was the last one? What do you remember? What problems did you have? Could you move arms and legs? Can you normally now? Did you have speech problems? How long did it last? Were you weak? Which side was affected? Anything you can't do normally now?
Pt Hx - What is the most difficult part of taking a stroke hx? The pt may be confused and have trouble with memory.
Pt Hx - What is the most important info to get during a stroke hx? Where the stroke occurred.
Pt Hx - What is the best question to ask to find out where the stroke occurred? Did you have any trouble using either of your arms or legs or did you have any funny feelings in either of them?
Pt Hx - What questions should you ask for a head injury hx? Where was your head hit? Did you lose consciousness? Is there anything you don't think you remember? Is there anything you can't do now that you could do before? Did you have any of these problems before the injury?
Pt Hx - One important difference to remember about a head injury pt is what? There is a difference between a head injury and a brain injury.
Pt Hx - What questions should you ask an intensive care pt's family? Why is pt in hospital? When were they admitted? What is the major problem? Is the neuro problem primary of secondary? Has a neurologist seen pt? (Check the report.) Have other neuro tests been performed (MRI, CT, EP)? What does referring want to know?
Pt Hx - Why is performing an EEG in intensive care difficult? Many other hospital personnel are caring for pt, may be a lot of technical interference from other machines.
Pt Hx - What is the most important question to have answered for the intensive care pt? What does the referring physician want to know (status, ECS, etc.). This will tell you how much time you need to spend with the pt and if you can maybe use less electrodes, etc. (not shorten the recording).
Pt Hx - What questions should be asked for sz pts? How often do they occur? When was the first one? When was the last one? Do you know when you are going to have one? How long do they last? Do you lose consciousness? What happens? Anything specific that causes it? Can you stop it? Is there a family hx?
Pt Hx - In sz pts, it's not uncommon for what? All other testing to be normal.
Pt Hx - In sz pts, what does the question 'When was your last one?" rule out? A post-ictal period.
Pt Hx - What is the term for an event that may look like a sz in some ways but have other features that are not true with cortical activity? Pseudoseizures or Psychogenic nonepileptic seizures (PNES).
Pt Hx - What questions should you ask a potential PNES pt? The same as a sz pt, but make more detailed notes of the 'differences' in answers.
Pt Hx - How should you treat a potential PNES pt? As a legitimate pt.
Pt Hx - What is the most important thing to do with a PNES pt? Use the 'power of suggestion.' "Szs are usually brought on by activation procedures. Just let me know if you have one."
Pt Hx - What questions should you ask for Non-Epileptic Paroxysmal events (dizziness, blackouts, falling, and fainting)? When did symptoms start? How often do they occur? Under what circumstances do they occur (only when standing, lying down, changing positions, enclosed areas, temperature related, seeing blood, haven't eaten all day, etc.)?
Pt Hx - What are you trying to rule out when evaluating a pt with Non-Epileptic Paroxysmal events? Possible sz.
Pt Hx - What is an important clarification to make with Non-Epileptic Paroxysmal pts? Try to get a precise term vs. general, such as... when the pt says 'dizzy,' do they really mean 'vertigo'?
Pt Hx - What is the purpose of taking a hx? To customize the clinical problem being evaluated.
Pt Hx - What should you do regarding the source of your information? Always list the source.
Pt Hx - How should you ask a pt's hx? At an age appropriate level.
Pt Hx - How much hx do you need? Enough for the EEGer to make an adequate clinical correlation with the EEG.
Pt Hx - What are some important jobs of the tech during hx taking? To be informative, make the pt feel relaxed, do not 'evaluate' or dx. Only describe. Never interprete.
What is American Electroencephalographic Society (AEEGS)? The formation of a national society for EEG technicians.
What is American Board of Registration of EEG Technologists (ABRET)? In conjunction with the AEEGS a committee was formed to set up an examination board.
What is American Society of EEG Technologists (ASET) - aka The Neurodiagnostic Society? The largest national professional association for those involved in study and recording of electrical activity of the nervous system. Organized in 1959. Members include techs, students, physicians and institutions involved in EEG, EP, polysomnography.
ECS What is the interval between the 2 examinations for a 1-18 year old pt? 24 hours.
ECS What is the interval between the 2 examinations for a 61 day to 1 year old pt? 24 hours.
ECS What is the interval between the 2 examinations for a 7-61 day old pt? 48 hours.
ECS What type of confirmatory test would a pt 1-18 years old need? 2 EEGs lapsed by 48 hours.
ECS What type of confirmatory test would a 61 day to 1 year old need? A brain perfusion assessment or 2 EEGs.
ECS What type of confirmatory test would a 7-60 day old need? A brain perfusion assessment or 2 EEGs lapsed by 48 hours.
ECS What type of pt may not be declared brain dead? Infants less than 7 days post term past 38 weeks (corrected for prematurity).
ECS When must a neurologist, neurosurgeon, or intensivist perform at least one of the 2 studies? When the subject is a pediatric pt.
ECS In what condition must the retest lapse for 12 hours? Non-structural cerebral damage (hypoxic-ischemic encephalitic).
OSHA- Sanitize: To clean or disinfect. To make more acceptable by removing unpleasant or offensive features. To make sanitary or hygienic, as by sterilizing to omit unpleasant details.
Sedation is most effective in these groups of pts: Children and restless adults.
ECS #8: What activation procedure(s) should you do? Demonstrate reactivity to pain stimulus. Also Auditory (AS) and Visual.
ECS What should the pt's temp be? 35 degree Celsius.
ECS What drugs should be avoided? Any that depress cortical function (barbs, benzos). Get serum levels.
ECS Artifact: Note ANY presumed artifact.
ECS When is a study considered in ECS? Only if there is no electro-cortical potential under these strict guidelines.
OSHA- What is the difference between sanitizing and disinfecting? The first reduces the number of microorganisms to a safe level. It doesn't need to eliminate 100% of all organisms. The second completely destroys all organisms on listed. Legally, must reduce pathogenic bacteria by 99.999% in less than 10 minutes.
What are the two primary responsibilities of the EEG tech during a sz? Put the pt at ease and keep them from harming themselves.
When is it non-contagious: Conjunctivitis Until drainage stops and therapy has been effective 24 h.
When is it non-contagious: Cold If febrile with productive cough.
When is it non-contagious: Unknown Fever Until afebrile 24 h.
When is it non-contagious: Acute Gastroenteritis Until diarrhea stop.
When is it non-contagious: Hepatitis A Until afebrile and no jaundice.
When is it non-contagious: Herpes Whitlow Until Lesions are crusted and dry.
When is it non-contagious: Herpes Zoster (Shingles) Lesions are crusted and dry.
When is it non-contagious: Influenza Until afebrile 24 h.
When is it non-contagious: Lice / Scabes Until effectively tx.
When is it non-contagious: Nibinyckeisus Until afebrile 24 h and effectively txed.
When is it non-contagious: Mumps Until afebrile and well. About 9 days after swelling onset.
When is it non-contagious: Pneumonia Until afebrile and txed, both for 24 h.
When is it non-contagious: Ringworm When tx initiated.
When is it non-contagious: Rubella Afebrile and no rash. About 7 days.
When is it non-contagious: Rubeola (Measles) Until clinically well.
When is it non-contagious: Open Skin Lesions Until tx and negative cultures.
When is it non-contagious: Sty Until no swelling or drainage.
When is it non-contagious: TB Until no longer infectious.
When is it non-contagious: Vericella Until last lesion has crusted over and dried. About 6 days.
When is it non-contagious: HBV and HIV Based on individual evaluation.
When is it non-contagious: Group A Strep 24 h after tx.
What are health care workers required to have? Vaccinations: Hep B, Influenza, Measles, Mumps, Rubella, Tetanus-Diphtheria toxoid. Also a bloodborne pathogen training yearly.
Created by: kmburg5840
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