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Unattended Intraoperative Neurophysiologic Monitoring
Best Practices > Professional Standards/Best Practices

ASET Position Statement
 
Unattended Intraoperative Neurophysiologic Monitoring
 
The ASET Intraoperative Neuromonitoring (IONM) Specialist Job Descriptions (March 2011) and the National Competency Skill Standards for Performing Intraoperative Neurophysiological Monitoring (March 2011) detail responsibilities, qualifications, and competencies of Neurodiagnostic/Neuromonitoring personnel. These recommended criteria are not met when unattended intraoperative neurophysiologic monitoring systems are utilized in the operating room for procedures requiring intraoperative monitoring of neural structures. Additionally, integrated, computer time-locked, detailed documentation of surgical events and monitoring data cannot be performed when neuromonitoring systems are unattended. 
 
In the best interest of patient safety, ASET strongly recommends the utilization of qualified Neurodiagnostic/Neuromonitoring personnel during all intraoperative Neuromonitoring procedures. Neuromonitoring is performed during surgical procedures in which the surgeon believes there is a significant risk of neurologic injury, including but not limited to, paralysis or loss of motor function. Due to the significant patient risk involved, ASET recommends that when intraoperative neuromonitoring is performed, ABRET CNIM credentialed*, competent** Neurodiagnostic/Neuromonitoring personnel participate to provide the following: detailed documentation of surgical events, modality specific anesthetic regime guidance, accurate and stable electrode placement, documented waveform description, correlation of critical periods of surgical procedures with documentation of recorded waveforms and communication to the surgeon, electrical safety precautions, troubleshooting expertise, recording instrument malfunction evaluation, and physiological and non-physiological artifact resolution, as detailed in the facility policy and procedure manual. 
 
 *More information about the ABRET Neurodiagnostic Credentialing and Accreditation (ABRET) Certification in Intraoperative Neurophysiologic Monitoring (CNIM) can be found at the website: www.abret.org  
 
**As described in the ASET IONM Specialist Job Descriptions (March 2011), and the National Competency Skill Standards for Performing Intraoperative Neurophysiologic Monitoring (March 2011). 
 
Please refer to the following website for additional information: www.aset.org (Best Practices tab).
                                                            Approved by the ASET Board of Trustees March 2012