Syllabus

QNM Training Syllabus

Week #1 Intro to IOM

  1. Introduction to IONM (1)
  2. OR Orientation (5)-HIPAA, OSHA, AORN, CPR, Infection Control, Sterile Technique, Needle Safety
  3. Field Orientation (2)-tech role in OR, supplies, communication (company phone list)
  4. Cadwell Orientation (1)
  5. OR IOM Paperwork (.5)
  6. General Anatomy (3)
  7. 10-20 System of Electrode Placement (3)
  8. OR tour (1)

 

Week #2 SSEPs

  1. Pre-Operative Exercise Sheet Technical (1)
  2. Pre-Operative Patient Interview and setup (2)
  3. IOM Technician Checklist (1)
  4. SSEPs- General (3)
    1. Definition
    2. Clinical use of EPs
    3. Types of EPs
  5. SSEPs- Stimulating and Recording (3)
    1. Stimulus methods and characteristics
    2. Recording parameters, methods and sites
    3. Amplifiers
    4. Filters
    5. Averaging
  6. SSEPs-Normal SSEPs to arm stimulation (3)
    1. Stimulus methods and characteristics
    2. Subject variables
    3. Stimulus characteristics
    4. Recording parameters
    5. General strategy of stimulating and recording
  7. SSEPs-Abnormal SSEPs to arm stimulation (3)
    1. Criteria distinguishing abnormal SSEPs
    2. General clinical interpretation of abnormal SSEPs to arm stimulation
    3. Peripheral lesions that cause abnormal SSEPs to arm stimulation
    4. Lesions of cervical roots and the cervical cord that cause abnormal SSEPs
    5. Lesions of the brain stem and cerebral hemisphers that cause abnormal SSEPs
  8. SSEP electrode placement
  9. OR

 

Week #3 SSEPs

  1. SSEPs-Normal SSEPs to Leg Stimulation (3)
    1. Normal SSEP’s at different recording sites
    2. Subject Variables
    3. Effect of stimulus parameters
    4. Recording parameters
    5. General strategy of stimulating and recording
  2. SSEPs-Abnormal SSEPs to leg stimulation (3)
    1. Criteria distinguishing abnormal SSEPs
    2. General clinical interpretation of abnormal SSEPs to leg stimulation
    3. Peripheral nerve and root lesions that cause abnormal SSEPs to leg stimulation
    4. Lesions of spinal cord and brain stem that cause abnormal SSEPs to leg stimulation
    5. Cerebral lesions that cause abnormal SSEPs
  3. SSEPs-Corrective Actions (1)
  4. SSEPs-Documentation (1)
  5. SSEPs-Anesthesia Requirements (2)
  6. SSEPs-Troubleshooting (1)
  7. SEPs-Cadwell Protocol building and tweaking (1)
  8. Practical Lab – SSEPs – electrode placement(3)
  9. OR

 

Week #4 S-EMG

  1. EMG –Introduction (3)
    1. Basic Overview of EMG
    2. S-EMG vs T-EMG
    3. Needle Electrodes, amplifiers
    4. Electronics
  2. EMG – Normal spontaneous activity (2)
  3. EMG – Abnormal activity (2)
  4. EMG – Anatomy for Needle EMG (5)
    1. Muscle ID
    2. Muscle actions
    3. Needle insertion points
  5. EMGs-Surgeries and Evidence based review of data (2)
  6. EMGs-Recording Responses (Bipolar vs Referential Montage), Filters, Timebase, etc
  7. EMGs-Anesthesia (1)
  8. EMGs-Troubleshooting (1)
  9. OR

 

Week #5 T-EMG/Train of Four

  1. Triggered EMG/Pedicle screw testing (2)
    1. Introduction
    2. Electronics
    3. Technical setup
    4. Probe, anode return
  2. Train of four (1)
  3. sEMG/Triggered EMG/Pedicle screw testing – Cadwell setup (2)
  4. EMG Documentation (1)
  5. Practical Lab – full setup on mock patient (3)
  6. OR

 

Week #6 MEPs

  1. TcMEPs-Overiew (2)
  2. Anatomy of motor pathway (4)
  3. TcMEPs- Electronics (1))
  4. TcMEPs-Stimulation vs. Recording (2)
    1. Electrodes
    2. Placement
    3. Parameters-intensity, train, ISI, duration/pulse width
  5. TcMEPs- Interpretation (2)
    1. All or none
    2. Threshold criteria
  6. TcMEPs-Surgeries (2)
  7. TcMEPs-Anesthesia (1)
  8. OR

 

Week #7 MEPs

  1. TcMEPs-Precautions (1)
  2. TcMEPs-Contraindications (1)
  3. TcMEPs-Troubleshooting (2)
  4. TCMEPs- Cadwell protocol building (4)
  5. TcMEPs-Documentation (1)
  6. Case Studies (1)
  7. Practical Lab (3)
  8. OR

 

Week #8 Multimodality Monitoring

  1. Literature Review (1)
  2. Assigning modalities to procedures. (4)
  3. OR – ‘mirror setup’

 

Week #9 Anesthesia and OR

  1. Anesthesia and IOM (4)
  2. OR – ‘mirror’ setup

 

Week #10 BAERs

  1. EEG test- must score greater than 80% to receive Certificate
  2. BAERs-Overview (.5)
  3. BAERs-Electrodes, Montages (.5)
  4. BAERs-Parameters (.5)
  5. BAERs-Interpretation (.75)
  6. BAERs-Surgeries (1)
  7. BAERs-Cadwell Setup (Montage, Template, etc) (1)
  8. BAERs-Anesthesia (.5)
  9. BAERs-Troubleshooting (.5)
  10. BAERs-Documentation (.5)
  11. BAERs-Case Studies (1)
  12. BAER – Practical Lab (3)
  13. OR – Full setup

 

Week #11 OR

  1. BAER test- must score greater than 80% to receive Certificate
  2. VEP Introduction and Overview
  3. CNIM Review
  4. OR – Supervised Cases

 

Week #12 OR

  1. CNIM Review
  2. Written Test and Practical Final