Neurodiagnostic Technologist (Memorial Healthcare)
Competency-based
ONET: 29-2099.01
1
Years
103
Skills
290h
Related instructions
Classroom instruction topics
- Fundamentals of Neuroanatomy
- Testing Procedures & Terminology
- Electrodes, Electrode Placement & Application Methods
- Fundamentals of EEG & Patient Care
- Digital EEG Concepts & Electrical Safety
- Normal Adult EEG, Normal Variants, & Drug Effects
- Instrumentation Part I Differential Amplifier, Montage Design & Filters
- Instrumentation Part 2 Waveform Analysis & Polarity
- Artifacts Identification and Troubleshooting
- EEG In Epilepsy
- EEG In Neurological Disorders
- EEG In Pediatric Patients and Neonates
- Introduction to Long Term Monitoring for EMU Personnel
- Setting Up Long Term Monitoring
- Patient Set Up: Phase I, Phase II, and Troubleshooting
- Instrumentation in LTM
On-the-job training
- Provides a safe recording environment by:
- Verifying identity of patient
- Cleaning electrodes after each procedure
- Following universal precautions for infection control
- Attending to patient needs appropriately
- Recognizing/responding to life-threatening situations
- Being certified to perform CPR
- Complying with lab protocols 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
- Establishes rapport with the patient and 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 mental capacity
- Evaluates the patient by:
- Determine the patient's mental age, mental state, and comprehension level
- Note the patient's overall physical condition
- Decide appropriate method of electrode application
- Ascertain the patient's capacity to cooperate with activation procedures
- Determine if hyperventilation is contraindicated
- Accommodate for disabilities or special needs
- Determine the need for additional physiological monitors
- Document unusual or inappropriate behavior suggestive of seizure or another event
- Determine the possible need for restraints or emergency intervention
- Prepares a patient history that includes:
- Patient information (name, age, ID number, doctor, etc.)
- Recording time, date, and graduate's name or initials
- Noting pertinent patient history and familial medical history
- Listing current medications/sedation and time of last dosage
- Noting time of last meal
- Noting time, date, aura, and circumstances of last seizure or symptoms
- Specifying the patient's mental, behavioral, and consciousness states
- Diagramming skull defects or anomalies (if any)
- Diagramming any modifications in electrode placement
- Electrode application follows a method that includes:
- Measuring and marking the head following the 10/20 measurement system
- Adjusting electrode placement for anatomical defects or anomalies
- Prepping patient's scalp prior to electrode application
- Applying electrodes with paste or with collodion and electrolyte
- Verifying electrode impedances are balanced and below 10,000 ohms
- Basic knowledge of analog EEG technology
- EEG
- Documents the working condition of a digital EEG instrument by:
- Calibrating system amplifiers
- Verifying standard filter settings
- Verifying sensitivity settings
- Inputting a biological (bio-cal) signal to all channels
- Correcting or reporting deviations as appropriate
- Obtains a standard EEG that includes:
- At least 20 minutes of technically acceptable recording (120 pages)
- 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 & reactivity
- Mental stimulation/assessment procedures
- Periodic checks of electrode impedance
- Natural drowsiness and sleep, if possible
- Notations of montage, filters, paper speed, & sensitivity setting changes
- Notes on observed behavior, clinical seizure manifestations, etc.
- 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
- Encouraging drowsiness and sleep
- Applying additional electrodes to localize abnormal activity
- Monitoring respiration if appropriate
- Monitoring ECG rhythms for abnormality
- Understands and follows technical criteria for:
- Recording electrocerebral inactivity (brain death)
- Recording in intensive care or cardiac care units
- Differentiates artifacts from cerebral waveforms by:
- Recognizing possible artifactual waveforms
- Documenting (on the recording) patient movements
- Applying/recording leads for eye potentials or other physiological potentials (i.e., respiration, EMG)
- Applying/recording leads for ECG
- Replacing electrodes exhibiting questionable activity or contact
- Troubleshooting for possible electrical interference
- When the EEG recording is finished:
- Removes electrode paste/glue from the patient's scalp and hair
- Describes clinically significant behavior
- Documents sedation used, dosage, and effects (if applicable)
- Reviews EEG for appropriate documentation of amplifier settings & montage changes
- Understands and has a working knowledge of:
- Functional neuroanatomy and neurophysiology
- Medication effects on the EEG background and waveforms
- Medical terminology and accepted abbreviations
- Signs, symptoms, and EEG correlates for adult neurological disorders
- Seizure manifestations, classifications, and EEG correlates
- Psychiatric and psychological disorders
- Maintains and improves knowledge and skills by:
- Reviewing EEG tracings with EEGer on a regular basis
- Reading journal articles
- Studying textbooks related to the field
- Attending continuing education courses in Neurodiagnostics
- Recognizes:
- Knowing how differential amplifiers work
- Computing voltage and frequency of waveforms
- Calculating the duration of waveforms
- Understanding the polarity of the waveforms
- Understanding impedance
- Understanding analog to digital conversion
- Knows how waveform displays are affected by:
- 60 Hertz filter
- Filter settings
- Sensitivity settings
- Paper speed
- Referential and bipolar montages
- Digital filters
- Electrode types and electrode material composition
- Malfunctioning equipment
- Recognizes
- Normal and abnormal variant awake and asleep patterns
- Abnormal awake and asleep patterns
- EEG patterns for levels of consciousness
- Clinical seizure patterns
- Introductory Polysomnography Studies (PSG)
- Must be capable of: 1. Recognizing sleep stages 2. Understanding the montages used in polysomnography 3. Initiating a technically adequate PSG by: A) preparing the patient; B) calibrating the patient and instrumentation; C) obtaining a ten-minute baseline recording 4. A basic understanding of common sleep disorders and treatment options 5.Performing the multiple sleep latency test (MSLT) and the maintenance of wakefulness test (MWT)
- Introductory Nerve Conduction Studies (NCS)
- Must have knowledge and understand: 1. Understand the anatomy and physiology of selected muscles and nerves 2. Have knowledge of neuromuscular disorders 3. Understand the principles of stimulation and accurate placement of recording electrodes 4. Understand the principles of measuring waveforms and distances used in routine nerve conduction studies
- Introductory Long-Term Monitoring (LTM)
- Must have knowledge and understand: 1. Understand the indications for long-term monitoring for epilepsy and basic LTM procedures including: A) ambulatory EEG B) monitoring with surface leads and intracerebral leads using video/EEG C) continuous EEG-intensive care monitoring 2. Have knowledge of the instrumentation for long-term monitoring 3. Have knowledge of treatment options for epilepsy 4. Recognize common seizure patterns
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