QNM Training Syllabus
Week #1 Intro to IOM
- Introduction to IONM (1)
- OR Orientation (5)-HIPAA, OSHA, AORN, CPR, Infection Control, Sterile Technique, Needle Safety
- Field Orientation (2)-tech role in OR, supplies, communication (company phone list)
- Cadwell Orientation (1)
- OR IOM Paperwork (.5)
- General Anatomy (3)
- 10-20 System of Electrode Placement (3)
- OR tour (1)
Week #2 SSEPs
- Pre-Operative Exercise Sheet Technical (1)
- Pre-Operative Patient Interview and setup (2)
- IOM Technician Checklist (1)
- SSEPs- General (3)
- Definition
- Clinical use of EPs
- Types of EPs
- SSEPs- Stimulating and Recording (3)
- Stimulus methods and characteristics
- Recording parameters, methods and sites
- Amplifiers
- Filters
- Averaging
- SSEPs-Normal SSEPs to arm stimulation (3)
- Stimulus methods and characteristics
- Subject variables
- Stimulus characteristics
- Recording parameters
- General strategy of stimulating and recording
- SSEPs-Abnormal SSEPs to arm stimulation (3)
- Criteria distinguishing abnormal SSEPs
- General clinical interpretation of abnormal SSEPs to arm stimulation
- Peripheral lesions that cause abnormal SSEPs to arm stimulation
- Lesions of cervical roots and the cervical cord that cause abnormal SSEPs
- Lesions of the brain stem and cerebral hemisphers that cause abnormal SSEPs
- SSEP electrode placement
- OR
Week #3 SSEPs
- SSEPs-Normal SSEPs to Leg Stimulation (3)
- Normal SSEP’s at different recording sites
- Subject Variables
- Effect of stimulus parameters
- Recording parameters
- General strategy of stimulating and recording
- SSEPs-Abnormal SSEPs to leg stimulation (3)
- Criteria distinguishing abnormal SSEPs
- General clinical interpretation of abnormal SSEPs to leg stimulation
- Peripheral nerve and root lesions that cause abnormal SSEPs to leg stimulation
- Lesions of spinal cord and brain stem that cause abnormal SSEPs to leg stimulation
- Cerebral lesions that cause abnormal SSEPs
- SSEPs-Corrective Actions (1)
- SSEPs-Documentation (1)
- SSEPs-Anesthesia Requirements (2)
- SSEPs-Troubleshooting (1)
- SEPs-Cadwell Protocol building and tweaking (1)
- Practical Lab – SSEPs – electrode placement(3)
- OR
Week #4 S-EMG
- EMG –Introduction (3)
- Basic Overview of EMG
- S-EMG vs T-EMG
- Needle Electrodes, amplifiers
- Electronics
- EMG – Normal spontaneous activity (2)
- EMG – Abnormal activity (2)
- EMG – Anatomy for Needle EMG (5)
- Muscle ID
- Muscle actions
- Needle insertion points
- EMGs-Surgeries and Evidence based review of data (2)
- EMGs-Recording Responses (Bipolar vs Referential Montage), Filters, Timebase, etc
- EMGs-Anesthesia (1)
- EMGs-Troubleshooting (1)
- OR
Week #5 T-EMG/Train of Four
- Triggered EMG/Pedicle screw testing (2)
- Introduction
- Electronics
- Technical setup
- Probe, anode return
- Train of four (1)
- sEMG/Triggered EMG/Pedicle screw testing – Cadwell setup (2)
- EMG Documentation (1)
- Practical Lab – full setup on mock patient (3)
- OR
Week #6 MEPs
- TcMEPs-Overiew (2)
- Anatomy of motor pathway (4)
- TcMEPs- Electronics (1))
- TcMEPs-Stimulation vs. Recording (2)
- Electrodes
- Placement
- Parameters-intensity, train, ISI, duration/pulse width
- TcMEPs- Interpretation (2)
- All or none
- Threshold criteria
- TcMEPs-Surgeries (2)
- TcMEPs-Anesthesia (1)
- OR
Week #7 MEPs
- TcMEPs-Precautions (1)
- TcMEPs-Contraindications (1)
- TcMEPs-Troubleshooting (2)
- TCMEPs- Cadwell protocol building (4)
- TcMEPs-Documentation (1)
- Case Studies (1)
- Practical Lab (3)
- OR
Week #8 Multimodality Monitoring
- Literature Review (1)
- Assigning modalities to procedures. (4)
- OR – ‘mirror setup’
Week #9 Anesthesia and OR
- Anesthesia and IOM (4)
- OR – ‘mirror’ setup
Week #10 BAERs
- EEG test- must score greater than 80% to receive Certificate
- BAERs-Overview (.5)
- BAERs-Electrodes, Montages (.5)
- BAERs-Parameters (.5)
- BAERs-Interpretation (.75)
- BAERs-Surgeries (1)
- BAERs-Cadwell Setup (Montage, Template, etc) (1)
- BAERs-Anesthesia (.5)
- BAERs-Troubleshooting (.5)
- BAERs-Documentation (.5)
- BAERs-Case Studies (1)
- BAER – Practical Lab (3)
- OR – Full setup
Week #11 OR
- BAER test- must score greater than 80% to receive Certificate
- VEP Introduction and Overview
- CNIM Review
- OR – Supervised Cases
Week #12 OR
- CNIM Review
- Written Test and Practical Final