Presenting a unique learning experience integrating lecture,
viewing of actual narrated surgical procedures, and hands-on workshops.
3 Day Course - 22.75 ACE credits
Overview of Basic Intraoperative Monitoring
Introduction to the Operating Room
Instrumentation Concepts
Neuroanatomy and Neurophysiology Related to Monitoring
Anesthesia
Spine Surgery Instrumentation
Spinal Cord Monitoring - TCeMEP
Spinal Cord Monitoring - SSEP
Spinal Nerve Monitoring - EMG
Cranial Nerve Monitoring
EEG Monitoring
Hands-On Workshops
The course begins with a brief overview to include a historical perspective, philosophy, modalities, and applications of Basic Intraoperative Monitoring. Discussion will also focus on who records and who interprets the data, professional societies, IOM credentials, and CPT codes and billing.
Students will learn the goal of intraoperative moniotring, basic terminology, aseptic and sterile techniques, operating room conduct for monitoring specialists, attire, roles, responsibilities, and communication of OR team members. Topics also covered include cautery use and safety, patient positioning, and Universal / Standard Precautions.
Students will become acquainted with the recording equipment by learning gain/sensitivity, filters, principles of differential amplification, polarity, near-field/far field recording methods & potential nomenclature, analog-to-digital conversion specifically horizontal ( sampling rate, dwell time, aliasing ) and vertical ( bit capacity ) resolution. You will learn the different types of stimulation used for SEP, TCeMEP, EMG, Auditory Evoked Potentials.
You will learn the brain and brainstem structures, anatomy of the vertebral column, auditory pathway, motor and sensory pathways of the spinal cord, muscles and nerve root innervation, and peripheral nerves associated with monitoring and cranial nerves. Also you will learn basic cell anatomy and function.
A basic understanding of anesthesia is mandatory for the monitoring specialist. You will gain an understanding of induction, maintenance, and emergence. You will learn about the role and perspective of the anesthesia specialist, trade and brand names of the more common anesthetic agents, methods of delivery, sedation issues, neuromuscular blockade, MAC, and narcotics. You will also learn how the BIS monitor is used and indications for and interpretation of cerebral oximetry. Students will also learn the physiological variables monitored by the anesthesia specialist and how these can effect monitoring.
Students will be introduced to the concepts of deformity correction including rotation, distraction, decompression, and spinal fusion. Also addressed will be the advantages & disadvantages, risk to neural structures, and the instrumentation / hardware used to correct spinal deformities such as; pedicle screws, anterior interbody cages, and posterior lumbar cages.
The sensory and motor pathways must be monitored to adequately protect the spinal cord. Somatosensory Evoked Potentials (SSEP) and Transcranial Electrical Motor Evoked Potentials (TCeMEP) will be presented. Transcranial electrical motor evoked potentials will cover patient set-up, anatomy of the voluntary motor pathway, neurophysiology of the corticospinal tract, stimulation parameters, recording and anesthesia protocols, alarm criteria, special considerations, risk factors, safety considerations and informed consent. TCeMEP case studies will highlight the conclusion of this most important component of IOM.
Somatosensory Evoked Potentials will include response generators, anesthetic considerations, patient hook-up, muscles to monitor, contraindications and risks, advantages and interpretation, and clinically significant changes. Discussion will include how to monitor the more challenging patients like those with cerebral palsy, peripheral neuropathy, or those with pre-operative baseline abnormalities.
Indications for spontaneous (free-run) and Triggered EMG will be presented and discussion will focus on how to determine spinal level appropriate for monitoring. Patient hook-up and indications for EMG monitoring such as pedicle screw cases are discussed and demonstrated.
Protection of the auditory and cranial nerves is an integral component of monitoring for skull base surgeries. You will learn the indications for Brainstem Auditory Evoked Potentials and EMG monitoring, responses, patient hook-up, anesthetic considerations, fisks and contraindications, and clinically significant changes.
Monitoring EEG during carotid endarterectomy surgery has become the standard of care at most facilities. Topics include patient preparation and hook-up, anesthetic considerations, and clinically significant changes.
Hands-on workshops are designed to teach you how to properly identify placement sites for stimulating and recording electrodes. Also facilitate understanding of stimulation methods, apppropriate montages, obligate waveforms, instrument parameters and recording techniques to adequately perform intraoperative monitoring.
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2008 Course Dates
April 3 - 5, 2008 (Thurs - Sat)
July 31 - August 2, 2008 (Thurs - Sat)
November 17 - 19, 2008 (Mon - Wed)
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Course Location
Holiday Inn & Suites
3155 Boardwalk Drive
Ann Arbor, MI 48108
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All Course Dates and Costs
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