#acute-critical

4 Minutes 

Check your voicemail 

Clean your wallet 

Sanitize your hands 

Delete your duplicate photos 

Make a new playlist (enhancing your brain) 

Make your bed 

Foam your hands 

Write a thank you note 

Update your PC software 

Text a friend 

Surf Facebook, Instagram or Twitter 

Wash your hands 

Did you see the subliminal messaging? Recent research shows that using an alcohol-based hand sanitizer does not work to kill germs unless it is used for approximately four minutes! If we persisted in life’s crises like the virus, how much more would we accomplish?  Do you foam for four? I certainly did not. I will now.  That stinking little virus for influenza A persists for up to four minutes.  Handwashing for four will do the same.  But it takes vigorous scrubbing and washing to get that little virus to die.   

The tasks listed above are all tasks that Mackenzie Horan claims can be done in less than five minutes. So, the next time you foam up, scrub in or wash up remember how long it took you to do the tasks above and savor that clean feeling. You are protecting yourself, your family and your patients by taking the time to do it right. Just in case you need a little extra encouragement or way to remember four minutes sing Bohemian Rhapsody by Queen. By the time you’ve finished foaming up you will be enhancing your brain through all the other times in your life you’ve heard that song and properly cleaning your hands.   

This quarter we want to bring our readers tips, suggestions and time-honored traditions of how we keep each other and our patients safe during influenza season and throughout the year.  

I work from home. I protect patients every day, despite being ill. I sit in my jammies, rocking that cup of Theraflu, a box of Kleenex and keeping everyone else healthy. 😊 All joking aside, it is crucial to the health of your coworkers, family, friends and patients that you properly sanitize your equipment, yourself and your environment. It is imperative that you stay home when you are ill.  Our loved ones deserve the best care possible whether that takes you an extra four minutes to thoroughly clean your hands or a test is delayed a day so that you can be on antibiotics for 24 hours.  What processes do you all follow to keep everyone healthy? 

        Foaming for Four Fabulous minutes,   

Petra N. Davidson, R. EEG/EP T., CLTM, FASET 

(Just had to throw in the CLTM!!  Just got those 4 little letters in September) 

Acute/Critical Care Neurodiagnostics
Ambulatory EEG
Autonomics
Clinical EEG (1)
Clinical EEG (2)
Department Managers
Epilepsy Monitoring (1)
Epilepsy Monitoring (2)
IONM
Nerve Conduction
Neurodiagnostic Education
Pediatrics and Neonatal
Technologist Entrepreneurs

Acute/Critical Care Neurodiagnostics

Author: Sabrina Faust, BS, R. EEG/EP T., CNIM, CLTM 

The importance of handwashing in the healthcare setting has become a standard of care and embedded in our culture.  We hear it all the time, the importance for reducing and eliminating Hospital-Acquired Infections (HAIs).  But what about environmental cleaning habits to prevent the spread of pathogens? You know, everything that the patient has touched before your next patient? Is there more that we could and should be doing to prevent the spread of infection from patient to patient?  

I recently came across a prospective cohort study, published earlier this year, funded by the Centers for Disease Control and Prevention (CDC), on clinical infectious diseases that reported 14 percent of the 399 hospital patients tested positive for a “superbug” antibiotic-resistant bacteria on either their hands or nares at, or near, time of admission.  And of those patients, nearly one-third of the patients’ room surfaces came back positive for contamination when testing commonly touched items in the room, such as the curtain, chair or nurse call light.  Another six percent of the 399 patients, who did not test positive upon admission, tested positive later in in their stay for newly acquired multidrug-resistant organisms (MDROs).  And of those patients who acquired the bacteria, one-fifth of the items tested positive with the same MDRO. 

This study demonstrates the importance of environmental cleaning to prevent the transmission of HAIs.  As a technologist, this encourages me to really think about our current culture when it comes to cleaning in between patients and which supplies are being used.  The CDC states that “any equipment or supplies labeled ‘Single patient use’ should be appropriately discarded after use. Reusable medical equipment should be cleaned and reprocessed appropriately prior to use on another patient.” 

I urge you to use the information learned to assess the current practices in your own facility to ensure that you and your patients are receiving the best care that you both deserve. 

Wishing everyone a safe and healthy holiday season! 

Web Resources: 

Clinical Infectious Diseases, Michigan Medicine – University of Michigan, DOI: 10.1093/cid/ciz092; Accessed November 4, 2019; https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciz092/5445425 

CDC Environmental Infection Control Guidelines https://www.cdc.gov/infectioncontrol/guidelines/environmental/index.html#anchor_1556905262 

Ambulatory EEG

Author: Christine Blodgett, MA, R. EEG/EP T., CLTM, FASET 

How do we protect our patients and coworkers?  The topic for these Interest Section articles focuses on protecting others from germs and illness during the flu season. However, in the midst of the current climate of coding changes in Ambulatory EEG, I thought I would give an update on how some in the field are working to protect our patients and our profession.   

In the past few months, coalitions have been formed to lobby Congress and the Centers for Medicare and Medicaid Services (CMS) to halt drastic financial cuts that were proposed for Ambulatory EEG monitoring.  If you aren’t aware, the proposed cuts would decrease reimbursements for these services by approximately 60 percent starting in January 2020.  This would have a far-reaching and serious impact on all facets of Ambulatory EEG monitoring all the way from our patients’ access to care to technologists’ jobs and how physicians, hospitals and private EEG monitoring companies work with patients moving forward.   

The coalitions worked in Washington DC to raise awareness of the realities of the time and costs involved in the process of performing Ambulatory EEG in the patient’s home, including everything from scheduling to setup and takedown, travel time, cost of materials, quality measures and maintenance to reviewing the data and preparing technical descriptions.   

As we all know, Ambulatory EEG is an invaluable tool that aids in the diagnosis of our patients in a way that is more comfortable, convenient and cost-effective to them than in a hospital setting.  For patients in remote locations without timely access to hospital-based testing, Ambulatory EEG helps limit wait times and access to care potentially resulting in delayed diagnoses which might otherwise be excessive.   

Luckily, the coalitions and EEG technologists who lobbied against these proposed changes were able to initially delay the proposed cuts, allowing an opportunity for the Ambulatory EEG community to provide CMS with additional data for a fair valuation of our services.  So, for 2020, we will see a new code set for Ambulatory EEG testing and the values of those testing services will be determined over the next several months.  

We should all be proud to see members of our EEG community step up to educate policymakers and Medicare officials and provide their expertise in efforts to support and protect our profession.  This fight is not over by any means.  Each of us as a practicing member of the Neurodiagnostics world has a voice that needs to be heard.  I urge all of you to educate yourselves on the issues and see how you too can help protect our patients and our profession.   

ASET’s own Governmental Advocacy Committee has made it easy for us to contact our government representatives and ask for their support to fairly value our services.  Please count yourself as a protector of our profession and step up to join the others in educating CMS and Congress about how essential our services are to our patients! 

Autonomics 

Author: Marcia Hawthorne, R. EEG T., CAP 

Thanksgiving and Christmas are my favorite times of the year.  Mostly because of all the time with family and friends.  Along with that though comes germs!  Two years ago, we were so disappointed that we had to cancel our holiday festivities, because three of the four people living in our house were sick!  This year I have been trying really hard to keep those icky germs away, but it’s inevitable that we will come in contact with something at sometime between now and the holidays.  So, we will continue to wash our hands, take our vitamin C and cross our fingers that we do not have to cancel any family time due to illness. 

In the hospital, as a whole, we have so many precautions in place to help keep the germ spreading to a minimum.  Handwashing campaigns and the infection control department are big advocates for keeping everyone healthy; as well as making sure to get our Flu Shot if we are able.  With the help of infection control, we are able to put policies in place in our own lab. 

In the Autonomic Lab, we are very careful to wash our hands frequently or use hand sanitizer when needed.  We wear gloves when hooking up the patients and masks when we have a cough.  We have signs in our waiting areas that asks our patients to “please wear a mask,” if they are feeling ill as well.  Many of our supplies are disposable but the things that are not are wiped down between each patient with Sani-Cloth wipes.  All of these practices and policies are to keep our patients healthy for the holidays and throughout the year.   

Clinical EEG 

Author: Pat Lordeon, R. EEG T., FASET 

Oh, we all know what the rules are:  handwashing is the best line of defense against infection, flu shots save lives, etcetera, etcetera, and etcetera.  Everyone knows what we should be doing, but at the risk of being the person who spills the beans—Do we actually follow the rules?  My guess is no.   

How many of you have worked when you should have stayed home?  How many have chosen not to get the flu shot?  How many skip breakfast or lunch because you are “too busy to stop and eat?”  Once in a while it may be okay, but day after day of skipping meals leads to poor eating habits, weight gain and susceptibility to illness.  These and other bad practices, put our patients (and us) at risk for sickness and worse.  But, we ARE busy, right? And when you call off, someone has to step up and fill your shift, right?  And then we feel guilty about calling off, right?  So, we work sick, and in the process, become the keeper of the primary germ – the germ that will, despite our best precautions, go on to turn the lab into a giant petri dish and infect everyone else. It happens all the time.   

Realistically, sometimes we HAVE to work when we would rather be home taking care of ourselves.  How do we protect ourselves, our patients and our coworkers during these times?  Obviously, hand sanitizer is your best friend… then, and always.  Masks keep our germs contained.  Wiping down equipment, phones, door handles… these things keep our coworkers healthy.  Keeping hydrated and having frequent, light meals, whether we feel like eating and drinking or not, are very important in helping us to recover.  But, when should we absolutely stay home?  Obviously, if you have a fever, vomiting or diarrhea you are persona non grata in the workplace.  If you are on antibiotics, it’s a good idea to stay home for the first 24 hours of taking the medication.  If you are unsure if you can work productively, it’s better to err on the side of caution and call off. Yes, it creates a bit of an issue for shift coverage but in the long run, it’s better for everyone.  When I was a manager, I much preferred for a tech to just call off rather than come to work sick and have to be sent home.  Why risk making everyone else sick just to make a point of how dedicated you are?  All your coworkers care about is how quickly you will be gone so they can sanitize everything you touched while you were there!! 

So, how do we stay healthy in the first place?  We all know the answer to this already: eat right, get plenty of sleep, exercise… Yeah, who has time for all that?  Okay, so maybe you can’t cook a gourmet dinner every night and maybe you don’t have time to exercise every day.  Do the best you can.  Squeeze in the exercise in on the job; take the stairs every day.  Have an apple with peanut butter instead of a candy bar.  Try to cook a couple meals on your days off and tuck them into the freezer.  Pull them out and put them in the fridge before you go to work, and when you get home they will be defrosted and ready to heat up.  Use your crock pot.  Use your instapot.  Use your imagination…. 

Sometimes the deck is stacked against us, and it seems like our work family are all under the weather at the same time, but everyone is still working.  In those cases, damage control is the only thing to do… Sanitize everything (multiple times a day!), wear masks, take Tylenol and be nice to each other.  At times like these, everyone is miserable.  Share your smiles, not your germs.  A little kindness goes a long way.  Remember, this too shall pass… So, hang in there and pass the hand sanitizer! 

Clinical EEG 

Author: Vicki Sexton, BS, R. EEG/EP T., R.NCS.T., CNCT, CLTM, FASET 

Since this topic is about going to work sick and spreading the flu or any other viruses to the patients who are already compromised, I will have to say, “GUILTY AS CHARGED.”  I will have to say that unless there were physical complications that compromised ability, I would be in work and I encouraged my employees into coming in also.  We were a very busy lab and when one person was out, it did make an impact on the rest of the staff.  I had ibuprofen, tums and canned soup, pairs of brand-new underwear and change of scrubs available, so that no one would have to go home. Terrible, I know. I am no longer a supervisor, but I teach now and tell my students “there’s no crying in EEG,” you have to be tough.   

So, I know what you’re thinking, “You’re infecting the patients!”  I would have the staff wear mask, they always either washed their hands, used sanitizer going in and out of the rooms, and anytime the machines went off the floor and we did a patient bedside, we ALWAYS wiped down the machines with either Sani-wipes or bleach every time before and after use. One of my techs was caught by Joint Commission when she didn’t know they were watching her wiping down the machine and they said they were impressed because they knew she was unaware of them watching her, and she was very meticulous about her cleaning!  If you do it as part of your routine it becomes automatic and it keeps our patients and us safe. 

Department Managers 

Author:  Kathy Johnson, R.EEG/EP T., RPSGT, FASET  

Winter has arrived here in wild, wonderful West Virginia… and our intrepid leader has suggested we might want to discuss how we cope with cold and flu season in our jobs.  To me this translates to the dreaded term “infection control,” and I am going to go somewhat off topic to talk about our newest infection prevention practice.  Recently this has become a favorite topic for me, and I am always happy to share and receive tips on how we can improve our processes.     

Just some brief history: When I started learning to do EEGs, we simply scrubbed the paste out of our electrodes with soap and water and used them on the next patient!  We also used reusable needle electrodes for EMG (although these did go down to Central Sterile for processing after use).  Today, these practices would be considered totally unacceptable by everyone involved including our Infection Prevention department, Joint Commission and me.       

During the time leading up to our last Joint Commission visit, we were (as usual) looking at all our policies, processes and practices to be sure we were compliant with JC standards.  In talking with our compliance and infection control folks, we felt like we could do a better job in a few areas.  One suggestion was that we consider the concept of single patient use “kits” for our procedures.  We took this idea and ran with it!  We developed an EEG kit with all single patient use items.  These kits are made up in a designated “clean” area during down time or by our volunteers and include everything we need for a study.   At the end of your testing it is all discarded—no more cleaning electrodes, soaking them in disinfectant or wiping down tape measures and china markers.  Here is our kit list: 

1. 1 disposable (paper) tape measure 
2. 1 single patient use, washable mini-marker 
3. 4 cotton tipped applicators 
4. 23 Disposable EEG electrodes 
5. 1 single patient container of paste 
6. 1 single patient container of prep 
7. 1 tongue depressor  
8. 24+ gauze squares 
9. 1 single patient roll of tape 
10. 4 gauze 4x4s for electrode removal 
11. 1 individually wrapped disinfectant wipe for wiping down headbox, cable, etc. 
12. 1 tube of collodion (not in every kit—for long term recordings) 
13. 1 single patient use bottle of collodion remover (not in every kit—for long term recordings) 

All this goes into a zip lock bag which is labeled with the date it was assembled, the earliest expiration date of any of the contents and the initials of the person who put it together.  Kits can be customized to the procedure—for example you might want to make up a kit for nerve conduction/EMG studies or sleep studies, etc.  I guarantee that Joint Commission will be impressed! 

In addition to helping reduce the transmission of colds and flu, utilizing single patient use items can reduce the incidence of hospital acquired infections (HAI) and thereby, length of stay, a key word in today’s healthcare environment.  While many would hesitate due to increased cost of disposables, it is well worth it if you prevent a HAI in just one patient.  What new practices do you have in your lab to help reduce HAI? 

Epilepsy Monitoring 

Author: Magdalena Warzecha, R. EEG/EP T., CLTM 

Health care employees caring for patients are at more risk of exposure to viruses than the general public. We can also spread viruses to our patients. Cold and flu viruses can be especially dangerous to patients with compromise immune system, elderly and young children. As healthcare employees, we need to protect ourselves and our patients against viruses during the fall and winter seasons when colds and flu are in full bloom. Organizations should have infection control policies and procedures in place to ensure both employees and patients are protected. 

In our company we implemented several policies and procedures to reduce exposure to viruses for our technologists and patients. 

1. Flu vaccine is the best protection against flu. The company requires annual flu vaccination for all personnel who have contact with patients, our goal is to achieve 100 percent compliance.  
2. Every fall we have infection control training to remind techs about modes of transmission, how long viruses survive on objects outside of human body, reiterate the importance of hand washing, following proper disinfection protocols and getting vaccinated against flu. 
3. 24 hours before every scheduled patient appointment we contact the patient by phone to confirm appointment and to fill out health questionnaire. Patients answer a series of questions regarding any new cold and flu symptoms, fevers, diarrhea, new rashes as well as recent exposure to infectious disease. If the answer to any questions is positive the appointment may have to be rescheduled.  

Despite all these measures technologists sometimes get sick. To protect our patients and co-workers we ask technologist to:  

1. Stay home if they experience flu like symptoms, fewer, cough, body aches until they are fever free for more than 24 hours 
2. Cover their cough if they have common cold 
3. Wear face mask and wash hands frequently 
4. Adhere to protocols for cleaning and disinfecting equipment and work areas  

If a technologist calls in sick, we make all efforts to keep all patient’s appointments, this may involve rearranging the schedule of other techs, working extra hours, travel to a different location or calling PRN help. Rescheduling patient’s appointments is the last thing we would do. The goal is for everyone to stay healthy during cold and flu season.    

Epilepsy Monitoring 

Author: Susan Hollar, EMBA, R. EEG T. 

Tips to keep the BUG Away 

The flu and virus season always brings added challenges to keeping a department up and running. Regardless of how you schedule and plan, multiple staff sick at one time is a challenge. This of course occurs when the hospital is also packed. Busy department and sick staff are not a good mix. 

One of the things we focus on is ensuring staff are getting breaks, scheduled days off and positive support. If people are tired, and weary their immune system takes a hit as well. Make sure you take a bit of time to at least drink fluids and rest your mind. 

During this season, we do extra cleaning of surfaces that are often touched. We wipe doorknobs, keyboards, phones, chairs and the break room a couple of times a day. We also do extra cleaning on the patient equipment.  

We also insist if someone is running a fever that they stay home for 24 hours past the last elevated temperature. Staff tend to want to come in and try but that does not pay off in the long run even if they wear a mask. Of course everyone gets a flu shot. We are not sure if that helps or not, but it is mandatory for our hospital.  

Each person can contribute by washing their hands often even in the lab when there are no patients. 

It is amazing to see our OCD tendencies surfacing during this season!  

Intraoperative Neurophysiological Monitoring (IONM) 

Author: Jeffrey R. Balzer, Ph.D., FASNM, DABNM  

“An Ounce of Prevention…”

It was in 1736 that Benjamin Franklin first famously said “an ounce of prevention is worth a pound of cure.”  It was at this time that Benjamin Franklin established the Union Fire Company in Philadelphia which quickly resulted in the development of standards and protocols for not just fighting fires, but for how to prevent them from happening. While Franklin’s original statement was with regards to fire safety, the axiom resonates loudly with healthcare operations as well. We all are aware that it’s easier to stop something from happening in the first place than to repair the damage after it has happened.  This certainly applies to our day to day operations in the operating room performing IONM.  As such, policies and protocols need to be established and in place to reduce and prevent untoward events such as infection or spread of infection to this vulnerable patient population the operating room. 

Our role as IONM providers with regards to infection control begins before we even enter the operating room.  This occurs in the form of a comprehensive IONM policy and procedure manual that outlines many of the points that I will mention here.  While some of these issues may seem trivial, they can go a long way in the prevention of infection and patient safety. 

Let’s begin with our own health which can translate directly to the health of our patients.  IONM providers should avoid coming to work if they are actively ill.  This is to protect not only the provider but also the patients with whom they interact.  I routinely see OR personnel who I would consider “sick,” yet they work all day and count on a surgical mask to prevent the spread of illness.  In addition to not coming to work sick, we need to be mindful of prophylaxis that can be helpful for the prevention and spread of disease.  A yearly influenza injection is a must for healthcare providers particularly those of us who have direct contact with patients and their families.  While often not a serious illness, contraction of influenza in patients who are already ill or have compromised immune systems can be fatal.  Get your flu shot! 

Let’s focus our attention now to the scrubs we wear every day into the OR.  How many people wear scrubs in from home and then enter the OR? How many people take a break, go outside to smoke or grab lunch and return to the OR in the same scrubs? Operating room attire should be reserved for the OR and the OR only.  If you do have to leave the OR in your scrubs you should wear a lab coat or cover-up and stay within the confines of the hospital.  This also applies to shoe covers which should always be worn particularly if you are wearing shoes from the outside.  We absolutely want to avoid bringing the outside world into the operating room and this is easily preventable. 

An often-overlooked source for spread of germs and infection is the surgical masks we wear into the OR.  Once you don a mask for entry into a sterile surgical suite, that mask should be removed and discarded and not left hanging around your neck once you leave the OR.  Moreover, a new mask should be donned should you enter a different sterile OR.  I have seen masks hanging around people’s necks with half of their lunch in the mask.  Take it off when you leave every OR and put a new one on before entering another OR.  Surgical masks are always readily available outside every OR. 

We can never overlook handwashing.  We are taught, for example, to never enter or leave a patient’s room without washing our hands.  While this is almost universally followed, I rarely see OR personnel wash their hands before entering the OR and putting on gloves.  This universal method to reduce the spread of germs and infection should be diligently followed in the OR as well.  As for the utilization of gloves when touching the patient for the electrodes to be placed, it goes without saying that this is mandatory.  Despite this, I see many caregivers in the OR not wearing gloves.  Be vigilant, have a box of gloves on your machine so that you can put them on before even approaching the patient if need be.  It is also wise to have hand-sanitizer on every system as well.  Preparation is important and having these items readily available rather than having to look for a box of gloves that is your size will save time and encourage usage. 

Now let’s talk about electrode application, skin preparation and handling sterile needles once in the OR.  Whether you are using sub-dermal needle electrodes, cup electrodes or adhesive electrodes, the skin should be prepped with an alcohol swipe prior to application.  This is of greatest importance when placing sub-dermal needle electrodes.  Once the skin is prepped, the needles should be removed from their sterile packaging, the protective tip removed, and the needle placed.  Needle electrodes should never be removed beforehand and placed on any surface in the operating room; they come as a sterile product for a reason.  Moreover, if you open electrodes for one case and for whatever reason do not use them, they should be discarded and not carried into another OR and used on a different patient.  The same holds true for opening or preparing sterile electrodes before you enter the OR in which they will be used.  This should only be done in the OR for which the electrodes will be used. 

Lastly, disinfecting equipment, including pods, wires, head boxes, etc., is of paramount importance.  This should be done after every case before you leave the OR and certainly before you use the equipment in another case.  We use germicidal disposable wipes for all of our equipment and more importantly store a container of these on every system.  Again, having these readily available promotes compliance. 

Our responsibility as caregivers in the IONM field is not solely related to the data we collect and how we communicate with the surgical team.  We have a responsibility to the patient to make sure that they are in the safest environment during their procedures and that the care they are receiving is that which we would expect should we be in their position.  This includes us taking great care to prevent the spread of germs and infection.  As stated above, there are numerous preventative actions we can take before, during and after surgical procedures to mitigate infection.  While some of these seem trivial and “no brainers,” it is always a good idea to have protocols in place and follow them in every case regardless of circumstances.  As Benjamin Franklin said, an ounce of prevention IS worth a pound of cure. 

Nerve Conduction Studies 

Author: Jerry Morris, MS, R.NCS.T., CNCT, FASET 

November has gotten off with a bang here in the south, especially in my neck of the woods in Louisiana. Thunderstorms and some tornadoes sprang up just before Halloween, clearing just enough Halloween day to give the trick-or–treaters a beautiful but cool evening to show off their finest and scariest costumes… Harry Potter attire seemed to be the costume of choice from the tiniest little ones to the older kids. Then Friday, the colder weather blew in. We even hit freezing on Saturday and Sunday and 70–80 miles north of us dipped into the high 20s! Way too early for those temps to be here…. Milder weather came back Monday and Tuesday and hopefully the crispness will continue throughout the rest of November. Although a little snow at Thanksgiving would be a beautiful site here with the trees still so colorful. Wishful thinking, I guess! 

Our topic for this Newsletter was supposed to be how our hospital and our labs keep our patients and ourselves safe during flu season. I would like to vary from that topic and talk a little bit about what is happening in the Neurodiagnostic world as it relates to electromyography and nerve conduction studies and preview what is to come in 2020… 

I just got back from the AANEM meeting in Austin, Texas in October. It was well attended by both physicians and techs. From the feedback I’ve heard and experienced, it was a great meeting in content with lively discussions. The Wednesday workshops open to the techs offered such topics as repetitive stimulation, blinks and cranial nerve testing, pitfalls, etc. with such noted speakers as Dr. Kimura, Dr. Bassam, Dr. Ferrrante and many others. The President’s Reception following the workshops allowed us to meet old friends and make new ones, as well as getting to see the latest technologies from the vendors. Thursday, Friday and Saturday offered great courses in demyelinating neuropathies such as GBS and CIDP, radiculopathies, upper extremity lesions and localization assessments, peripheral anatomy from the root to the muscle and other topics related to ALS and neuromuscular junction disease.  And to top it off, Saturday’s final session was a spirited game of NCS Jeopardy between three outstanding teams; a fitting way to end a great meeting. A big shout out to Teresa Spiegelberg for getting all the answers and questions done! 

In 2020, AANEM will meet at the JW Marriott Grande Lakes in Orlando, Florida on October 7–10.  Probable course content for the technologists may include neurophysiology, NCS pattern recognition, anomalies and variants, technical aspects of NCS, etc. More topics may be defined after the meeting feedback has been studied better. If possible, more hands-on workshops from basic to advanced will be incorporated, probably on Wednesday. A meet-and–greet coffee/social hour may also be included between the end of the workshops and the start of the President’s reception. And always the dinner get–togethers are a great way to socialize and talk over old times. Log in to aanem.org for updates as 2020 begins as well as for information on the CNCT exam and checkpoints. 

AAET has also been active this year. They met this past spring in Austin, Texas as well. Their annual meeting included hands–on workshops and lectures, as well as two days of just lectures. I was honored to be one of the speakers. The meeting was well attended and enjoyed by all.  By the time you read this, the AAET Fundamentals course in Clearwater, Florida will be over. Look for it next year around the same time, I believe. The 2020 AAET annual meeting will be in Knoxville, Tennessee, on April 16–18 at a TBD site. It will offer 12 hours of NCS workshops, 12 hours of comprehensive lectures, and 24 CEUs allotted. Check back at aaet.info for more meeting information as well as information about the R. NCS. T. exam. 

And last, but certainly not least, ASET will have their annual meeting at the Town and Country Resort in San Diego, California, Aug 20–22, 2020. Usually the NCS course block is on Friday, with morning and immediately after lunch lectures and the hands-on workshops later in the afternoon. And don’t forget the online NCS courses offered all year. Contact aset.org for any information and Maureen Carroll for specific online course information. 

Thanks for letting me stray from the norm for this portion of the newsletter. Have a wonderful holiday season and new year. If you have any questions, please feel free to email me at [email protected]  or call me at 318-617-0970. Leave me a message if I don’t answer and I will get back to you as soon as I can. See you in San Diego!! 

Neurodiagnostic Education

Mark Ryland, AuD, R. EP T., R.NCS.T., CNCT, RPSGT 

In the college’s neurodiagnostic labs, we require our students to wash their hands before doing any 10-20 or other hookups, even when initially practicing on glass heads and manikins. This prepares them for working with actual patients (including practicing on each other). 

Any procedures done on classmates (and eventually patients) REQUIRE gloving. 

We also require washing hands during a procedure if electrode correction is necessary. We pretty much use the standard 10-15 seconds of vigorous washing with soap. 

This may be off the overall topic, but our Neurodiagnostic Program obviously requires our students to get flu vaccinations, as these are required to attend clinical rotations. My humble opinion on individuals who do not believe in vaccinations can’t be printed, so I will just leave that up to your imagination. 

Pediatrics & Neonatology 

Author: Lea Salas, R. EEG/EP T., CLTM 

Staying healthy during cold/flu season is difficult but you can do something to try to stay healthy during this season and all year long.   All year long, I make sure I eat lots of fruits, vegetables, and extra Vitamin C approaching the “cold” season.  Staying active, getting enough sleep and relaxation helps me get through the six months of gray sky here in Seattle during the cold season.  

Seattle Children’s (SCH) requires all of us to have flu shot; I also make sure that everyone in my household gets the flu shot. 

 On handwashing, my belief is to follow the policy/procedure for our hand hygiene every day then I know I do my part protecting my patients and myself not only during the flu season.  Sanitize or wash hands before wearing gloves.  Wearing gloves are an adjunct to, not a replacement for, hand hygiene.    We are also supposed to use lotions available only through our Central Services because, per our guidelines, “studies have indicated that lotions have the potential to become contaminated, serving as reservoirs for outbreaks of healthcare associated infection.”   

I do not go to work when I feel sick or have symptoms of sore throat, cold and fever.  We have to be fever- free for at least 24 hours before going back to work.  I wear mask when I have a cough regardless of whether or not I am still “contagious.”  Here at SCH, patients and families are required to wear a mask when they have a cough so we as a group follow the same policy. 

Wiping our equipment, beds, head box, keyboards, etc., is our standard practice after all studies we perform.  We use Cavicide wipes and wipes with bleach for MRSA, cDiff, TB patient and other communicable diseases.  We also use disposable electrodes on all our patients.   

Technologist Entrepreneurs 

Author: Janna Cheek, R. EEG T., CNIM 

As most, I too love the fall season with the beautiful colors and crisp fresh air here in the central US.  We don’t get snowed in like a bit further north however we do have an occasional “hard winter” that includes snow and ice.  The many rivers, lakes, foothills and mountain ridges also add to the beauty of Oklahoma.  But now the real hard-core truth hits; all this beauty does not make us immune or any easier to deal with and get through than the flat plains of the panhandle, beach sands, Rockies or Smokies.  

So, we all need to fight the BUG(s) by washing our hands and covering our cough whether it is at home, in our office, in the patient room or the OR unit.  It is now mandatory in our region for every healthcare worker to have the flu vaccine before we can carry out any patient care and I’m sure this has now become universal with all health care workers. 

Our company has each new hire review our employee handbook where the handwashing instruction and policy is highlighted.  An annual mandatory staff meeting on handwashing technique is also performed so that all employees are made well aware of the importance of staying healthy by taking all preventative measures.  Our handwashing policy includes using water, soap/foam and vigorous rubbing hands, together which includes palm, between fingers, under nails and even around and above wrist as we sing or hum happy birthday to ourselves or even aloud to remind those around us of the importance to wash those germs off before and after we enter a patient room, after going to the bathroom and before and after eating.  

WOW – that’s a lot of down time each day you say.  The average time it takes to sing Happy Birthday while washing is about 20–30 seconds.  We urge each handwashing technique to last no less than 30–45 seconds which means two rounds of the happy birthday tune.   

So bottom line is that handwashing is the simplest and most effective way to cut down on the spread of diseases, colds and flu.  Our hands stay dried out and in the upcoming winter months crack and become painful.  We keep plenty of lotions and ointments available for these encounters; it’s a lot less expense than time off with multiple staff members being sick.