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www.a set .org MARCH 2009 Volume 33, Number 1 w ww. as et . org ASETnews Representing the electroneurodiagnostic profession Celebrate END Week April 19 – 25, 2009! 2009 END week is sponsored by ASET and DO Weaver & Co. E lectroneurodiagnostic week is celebrated annually during the 3rd week of April. It is a week-long event to demonstrate pride in the profession and in the individual accomplishments of electroneurodiagnostic technologists throughout the world. It is also an excellent opportunity to educate others, recruit new students into the profession and to promote END awareness in the community. Below are a few ideas for your END Week celebration. • Apply Fp1 and O2 on visitors to your booth/department and run a brief tracing, asking the patient to blink, smile, move his/her head, close his/her eyes, and the like • Download the END Week press release template from the ASET website and send to your local media and allied health organizations in your community • Have an open house in the END Department and give out brain erasers and add fun things like Brain Jell-O molds • Host a patient's health fair on epilepsy and END services • Make art projects out of old paper EEGs for display • Pass out informational brochures on a career in electroneurodiagnostic technology, a patient’s guide to testing, or our most recent brochure describing electroneurodiagnostics in layperson terms • Put up a poster display in the hospital lobby or wherever educational materials are allowed • Recognize technologists in your department with END week gifts, such as a lunch cooler, clipboard, or cool lighted pen; offer a special lunch for technologists • Visit a 7th or 8th grade science class and talk about EEG, brain injuries and seizures • Visit www.aset.org for more ideas and printable documents, including an assortment of brain teasers Continued on page 5 왘 IN THIS ISSUE: 6 ASET Membership 101 – ASET Forums 11 ASET Sets the Gold Standard 14 Tech Tips: Multidrug-Resistant Organisms 18 ASET 2009 Annual Conference Course Schedules 20 Interest Section Briefings Call for Nominations for 2009 ASET Distinguished Service Award T he ASET Distinguished Service Award honors individual members for exemplary service and contribution to the Society and/or to the electroneurodiagnostics profession. Awardees receive a congratulatory letter from the ASET President with a copy to the recipient’s CEO and supervisor, recognition and award presentation at the 2009 Annual Conference, recognition in the ASET newsletter, and complimentary ASET membership for the following member year. 2008 marked the first time the Distinguished Service Award was given. Two very deserving members, Judy Ahn-Ewing, R. EEG/EP T., CNIM, and Lew Kull, R. EEG/EP T., CLTM, MA, were last year’s recipients. To nominate an ASET member for this award, all you need to do is complete the brief nomination form, and e-mail, fax or mail it to the ASET Executive Office along with the required supporting documentation. The nomination form may be downloaded from the ASET website by CLICKING HERE. The deadline for submitting nominations is May 15, 2009. Continued on page 5 왘 Contents BOARD OF TRUSTEES. . . . . . . . . . . . . . . . . . . . . . 3 ASETnews Volume 33, Number 1 • MARCH 2009 ASET S TAFF : S PECIAL S ERVICES FROM THE EXECUTIVE DIRECTOR’S DESK . . . . . 4 MEMBERSHIP NEWS & SERVICES. . . . . . . . . . . . . 6 ASET FOUNDATION . . . . . . . . . . . . . . . . . . . . . . 9 EDUCATIONAL AND PROFESSIONAL DEVELOPMENT . . . . . . . . . . . . . . . . . . . . . . . . . 11 TECH TIPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 2009 ANNUAL CONFERENCE . . . . . . . . . . . . . . 16 INTEREST SECTION BRIEFINGS . . . . . . . . . . . . . 20 CREDENTIALING ORGANIZATIONS . . . . . . . . . . 25 READY REFERENCES . . . . . . . . . . . . . . . . . . . . . 26 WORKSHOPS, COURSES AND SEMINARS . . . . . . 27 CALENDAR OF EVENTS . . . . . . . . . . . . . . . . . . . 28 ASET Staff from left to right. Back row, Arlen Reimnitz, Maggie Marsh-Nation, Debi Rosa. Front row, Sarah Ecker, Lucy Sullivan, Faye Mc Nall. EXECUTIVE DIRECTOR Arlen Reimnitz ASET Executive Office 6501 East Commerce Ave., Suite 120 Kansas City, MO 64120 816.931.1120 [1#]; 816.931.1145 fax [email protected] ONLINE EDUCATION Maggie Marsh-Nation, R. EEG/EP T., CNIM 2013 Lime Creek Rd. Kerrville, TX 78028 830.895.7460; 830.895.7461 fax [email protected] DIRECTOR OF EDUCATION Faye Mc Nall, R. EEG T., MEd 319 Alewife Brook Pkwy Somerville, MA 02144 617.764.5087; 617.628.7087 fax [email protected] MARKETING AND COMMUNICATIONS MANAGER Sarah Ecker ASET Executive Office 6501 East Commerce Ave, Suite 120 Kansas City, MO 64120 816.931.1120 [3#]; 816.931.1145 fax [email protected] DIRECTOR OF PUBLICATIONS Lucy Sullivan, R. EEG T., CLTM 3350 S 198th Rd. Goodson, MO 65663 417.253.5838; 417.253.3069 fax [email protected] MEMBERSHIP SERVICES ADMINISTRATOR Debi Rosa ASET Executive Office 6501 East Commerce Ave, Suite 120 Kansas City, MO 64120 816.931.1120 [2#]; 816.931.1145 fax [email protected] O UR M ISSION The ASET Newsletter [ISSN0886-5620] is published quarterly by the American Society of Electroneurodiagnostic Technologists, Inc., 6501 East Commerce Avenue, Suite 120, Kansas City, MO 64120, 816.931.1120. Periodical postage paid at Kansas City, Mo. The portion of the yearly dues required for subscription is $19.00. Subscription by membership only. Postmaster: Send address changes to ASET Newsletter, 6501 East Commerce Avenue, Suite 120, Kansas City, MO 64120, USA MARCH 2009 • Volume 33, Number 1 The American Society of Electroneurodiagnostic Technologists, Inc. [ASET] provides leadership, advocacy and resources that promote professional excellence and quality patient care in electroneurodiagnostics. As a membership organization, ASET advances the field of electroneurodiagnostics by serving member needs, defining and endorsing standards of practice, providing innovative educational opportunities, promoting the profession and building coalitions in allied health and other communities of interest. ASETnews 2 BOARD OF TRUSTEES PRESIDENT’S MESSAGE By L. Elizabeth Mullikin, R.EEG/EP T., CNIM, MPA, MA, MNM ASET’s Membership Grows – Our society will attain the largest enrollment in history. I am pleased to inform you that ASET’s membership numbers have surpassed previous years in the second month of this enrollment year 2009. Our greatest growth is in Institutional memberships, which has increased 16%. Excluding Institutional members, the overall membership enrollment has increased 14.5%, or 257 more new and renewing members compared to same period in 2008. The Membership Committee is working along side the Board of Trustees and the Executive Office executing a membership growth strategy not only to build our Society numbers but also to cut through a challenging roadblock that plagues national organizations. With foresight, the ASET Board of Trustees set forth a goal to identify electroneurodiagnostic technologists who are found working in the field, who are not association members, and who may not have opportunities for education as well as information about the certification process. ASET’s Institutional member class enables the Society to identify and capture information about electroneurodiagnostic technologists employed by organizations, facilities and professional practice that would have otherwise been overlooked. The break-through tactic for Institutional membership was adding specific value added education programs and direct employee access to Society resources. Timing is everything and the ASET Board of Trustees understands that during this time of economic downturn specific categories of membership will support technologists in their professional careers. For enrolled members, ASET’s Member-Get-A-Member program is designed for a member to earn a 2010 non-dues membership by signing up four new Active members. “Trusteeships are so in” The ASET trustee is increasingly important as the crucial success factor for ASET. Over the last several years the Board of Trustees has transitioned into a “strategic board.” Two of the fundamental roles for the trustees are to ensure continuity of leadership and to ensure that a sound strategy for the success of the Society is in place. The Board of Trustees represents interests of the member. The great value of the board is how the trustees guide the executive director through major decisions. This is where trustees really add value. An effective board is a “trust” of experience, intellect and energy. Put together they are an enormous asset and resource for the Society. Your governing board is defining tomorrow. We will continue to build the value of ASET while deepening the hallmarks of quality in education, advocacy and service for a positive momentum in our professional lives that mark our tradition of 50 years. As we reflect on 50 years of tremendous advances, a persistent passion for our field and neurological diagnostics in patient care know that this brings us together as “society” to sustain us throughout complex circumstances and to build our future. This is what makes the foundation of ASET. 쎲 MARCH 2009 • Volume 33, Number 1 ASET OFFICERS PRESIDENT L. Elizabeth Mullikin, R. EEG/EP T., CNIM, MPA, MA, MNM Pasadena, CA 626.710.0250 [email protected] PRESIDENT ELECT Leisha L. Osburn, R. EEG/EP T., CNIM, DABNM, MS Indianapolis, IN 317.962.8563 [email protected] SECRETARY/TREASURER Kathy Johnson, R. EEG/EP T., RPSGT Huntington, WV 304.526.1880 [email protected] TRUSTEES Kimberly Ann Ellis, R. EEG/EP T., CNIM Tampa, FL Janet K. James, R. EEG T., R. NCS T. Ft. Walton Beach, FL Sharyn Katz, R. EEG T. Valhalla, NY Brian Markley, R. EEG/EP T., R. NCS T., BS Silver Spring, MD Michelle Nagel, R. EEG/EP T., CNIM, BS Greenfield, IN Sandra Nylund, R. EEG/EP T., CNIM, BS Great Falls, MT Riki Rager, R. EEG T., BS Tuscaloosa, AL Kristin Roberts, R. EEG/EP T., AS Long Beach, CA Mark Ryland, R. EP T., RPSGT, R. NCS T., MA Parma, OH Michael Vanasse, R. EEG T. Providence, RI Lois Wall, R. EEG/EP T. Durham, NC ASETnews 3 FROM THE EXECUTIVE DIRECTOR’S DESK ASET Board Adopts Position Statement in Support of END Licensure By Arlen Reimnitz I n 1991, ASET was neutral on the position of licensure for the END profession. It had, however, developed a model licensure bill in the event individual states wanted to pursue such action. Due to dramatic changes in the health care environment since that time, a review of the Society’s position on licensure was requested by the Board in August 2003. Included as part of that review was the commissioning of a white paper from an outside consultant to objectively present information about occupational regulation. As the result of that review, in 2004 the ASET Board of Trustees adopted a new position statement on occupational regulation. The statement reads in part, “The American Society of Electroneurodiagnostic Technologists supports programmatic educational accreditation, appropriate electroneurodiagnostic credentialing, compliance with evidence-based national practice standards, adherence to the END scope of practice, and occupational regulation. These requirements will help ensure safe practices quality care, and pertinent education and skills for the profession of electroneurodiagnostic technology. Occupational regulation of END practitioners may be in the form of licensure, statutory certification, or registration.” Since 2004, ASET has been moving toward oversight for the END profession. Also since 2004, the health care environment has continued to undergo shifts and changes, and the area of occupational regulation of the allied health professions has not been unaffected by these changes. For examples, respiratory therapy has received licensure in almost all 50 states; interests representing polysomnography has been working on licensure in a number of states, including most recently the states of California, New York, Hawaii, and Kansas. Therefore, at its February 2008 midyear meeting, the Board of Trustees unanimously approved the recommendations of the Governmental Advocacy Committee to authorize the committee to draft a position statement in support of licensure for the END profession, and to draft a model practice act for board consideration. At its February 2009 mid-year meeting, by unanimous vote the Board of Trustees adopted the following position statement on licensure: “Occupational regulation is a necessity in many allied health fields to protect the health, safety and welfare of patients. Regulation gives clearly defined scopes of practice for each occupation and defines who is qualified to be a professional in each field. The public benefits as a result of the professionals being able to concentrate on clearly established guidelines and requirements within their scope of practice. MARCH 2009 • Volume 33, Number 1 Although there are existing certificates and registrations for the electroneurodiagnostic profession, these are voluntary and are not a requirement for employment or to practice. Although becoming a registered or certified technologist in one or more of the modalities that comprise electroneurodiagnostics is an indication to the public and employers that a person has sought and achieved competency, it is not a guarantee that the public is universally protected as it allows for individuals who do not take the voluntary examinations to practice. To assure the public that each electroneurodiagnostic procedure performed is conducted by only qualified personnel, it is necessary to have in place a regulation that is enforceable by law. ASET believes that occupational regulation in the form of state licensure is the most effective means to establish legal authority for the scope of practice for electroneurodiagnostic professionals.” Also by unanimous vote, the ASET Board of Trustees approved a model bill for the state licensure of the electroneurodiagnostic practice as recommended by the Governmental Advocacy Committee. The model bill provides the basic structure and provisions for what should be included in END licensure legislation at the state level. The model bill includes: providing for licensure and regulation of electroneurodiagnostic technology; providing for and documenting the registration and licensure of END practitioners; regulating the field of END technology in a state; creating a state END licensure board; creating a state END licensure board fund; providing for an appropriation to the state board from the fund in an amount deemed necessary for the fiscal year; providing for duties and powers of the board; and prescribing penalties for violations of the act once enacted into law. In adopting the model bill, the board noted that it is not the function of ASET to get involved in the nuts and bolts of licensure legislation proposed in each state, or to fund individual states’ licensure initiatives. It is the function of ASET to provide the framework for how to go about achieving licensure. The model bill is intended to be modified to meet the specific needs of state and grassroots organizations. A copy of the model bill can be viewed and downloaded by visiting www.aset.org and clicking on the “Advocacy” tab. Soon to be added to the site will be a primer for moving a licensure bill through the state legislative process. A publication that may be of interest to groups considering an END licensure initiative in their state is the Guide to State Legislative Lobbying Revised, by Robert L. Guyer. This publication is a “onestop-shop” for lobbying strategies and tactics. It is available for purchase through Amazon.com. Continued on page 5 왘 ASETnews 4 COVER STORIES continued Celebrate END Week April 19 – 25, 2009! Continued from Front Page The mission of Electroneurodiagnostic week is to; • Honor and thank electroneurodiagnostic professionals for their contributions • Demonstrate the value of electroneurodiagnostic technologists in all healthcare settings • Promote END in the workplace and the community • Increase awareness of neurological issues in all environments • Educate and encourage prospective students about career opportunities and growth of the profession 쎲 Call for Nominations for 2009 ASET Distinguished Service Award Continued from Front Page The ASET Membership Committee is charged with reviewing all award nominations and selecting recipients based upon the following criteria: 1. The nominee is an ASET current member with at least three years of consecutive membership. 2. A supporting letter from the nominator that speaks to the following attributes (if applicable): a) Demonstrated active participation at the national and local levels through leadership or committee participation, program planning and special presentations (including generating visibility for the profession such as END Week efforts), product or publication development, and special task force participation or completion of special projects. b) An ambassador exemplifying the profession c) Demonstrated success in the profession d) An individual maintaining the highest ethical standards More than one Distinguished Service Award may be presented per year based on nominations and at the discretion of the Membership Committee. Objective criteria will be utilized in judging the nominations. The award recipient(s) will be announced, and the award will be presented, at the Annual Business Meeting & Awards Luncheon held in conjunction with the 50th Anniversary Annual Conference, August 5-8, 2009, in Phoenix, AZ. The current ASET President and ASET staff are not eligible for the award. 쎲 From the Executive Director’s Desk Continued from Page 4 Governmental Advocacy Committee Monitors Legislative and Regulatory Activities One of the charges of ASET’s Governmental Advocacy Committee (GAC) is to monitor state and Federal legislative and regulatory proposals that affect the END community. Each GAC member has been assigned a group of states to regularly monitor and report on activities. The list of state monitoring assignments and contact information for GAC members is posted on the Members Only section of the ASET website under the “Advocacy” tab. News on pending and proposed state legislation, licensure, changes in procedural coding, and Medicare and Medicaid issues affecting the END profession also are now regularly posted and updated on the Members Only section of the ASET website. You can obtain more details on particular postings, including full text of bills, contact information for committees to which bills have been assigned, and the like, by contacting the GAC member tracking the state in which you have an interest. 쎲 SAVE THE DATE . . . ASET 2009 Annual Conference The Gold Standard August 5-8, 2009 Arizona Biltmore Resort & Spa Phoenix, AZ MARCH 2009 • Volume 33, Number 1 ASETnews 5 MEMBERSHIP NEWS & SERVICES ASET Membership 101 How to Access the ASET Forums Using the ASET Website W ondering how to staff 24/7, anesthesia for TCMEPs, how to calm children, what CPT code to use…? The ASET Forums are an interactive way to ask fellow technologists, to discuss procedures, to find products, and to debate how things should be done. There are 15 separate forums – from Acute/Critical Care to General END Topics to Polysomnography. The discussions on the Forums are meant to stimulate conversation not to create contention. The Interest Section Forums Guidelines on the opening page describe how to enter the forums, rules, etiquette, and ASET’s responsibilities. Please take time to review these guidelines. To access the Forums: 쐃 Go to the ASET website: www.aset.org Earn a 1-year Free Membership – ASET 5000 Update H elp ASET advance the END profession and become a force for advocacy by reaching its strategic imperative of 5,000 members… AND get a 1-year free membership in the process. Continuing with our belief that current members are the best spokespeople and promoters of the Society, ASET is offering a free membership for one year to any Active, Associate or Student member who sponsors four NEW Active members for the 2009 membership year! To sponsor a new member, all you need to do is have him or her enter your name where it asks for the “Sponsoring Member/Who Introduced you to ASET” on either the hardcopy or online member application form. Members who successfully sponsor the minimum of four new Active members for the 2009 member year will have their 2010 dues payment waived. Some tips for recruiting your co-workers and colleagues: • Download and print the Individual Membership Application from the ASET Website (click on “Download Individual Application” under the Membership Tab). In the sponsoring member field, enter your name. Then, tell your member prospect how your membership in ASET has helped you and why you think they could equally benefit. Hand them the application, and invite them to join. Remind them that if they join after April 1, their first year Active member dues is only $60, and their membership runs through the end of December 2009. • Take a couple minutes from your day to walk them through the online application process and when it asks who introduced them to ASET, make sure they enter your name. To access the online form, click on “Join Online Individual Membership” under the Membership tab of the ASET website 쎲 쐇 Log in as an ASET member. 쐋 On the Members Only Welcome page, click on ASET Forums. 쐏 In the middle of the Interest Section Forum Guidelines click on, “Click here to visit the ASET Interest Section Forum.” First time users will need to register to view or post a message on the forum. Follow the directions on this page to register. 쐄 The list of 15 forums will appear. Click a forum from the list. Click on New Topic on the right above the threads to start a new conversation. To enter an ongoing conversation, click on the title. 쐂 Enjoy sharing, teaching, debating, and learning with other technologists. 쎲 1959 - 2009 Celebrating 50 years of Serving Electroneurodiagnostic Technologists MARCH 2009 • Volume 33, Number 1 ASETnews 6 MEMBERSHIP NEWS & SERVICES continued Congratulations to Our New Members [Since 09.12.08] Institutional Members Bromedicon Carolinas Medical Center NorthEast Conemaugh Memorial Medical Center DENT Neurologic Institute Forsyth Medical Center Hattiesburg Clinic Medical Center Clinic Neurodiagnostic Labs Nihon Kohden America Sandia Neuromonitoring St Joseph's Regional Medical Center Winchester Neurodiagnostic Lab Individual Members Ronier Abarca Patricia Adams, R. EEG T. Gary Adrian Talaat Agha Keith Al-Dijaili Jorge Alvarez Gary Amaral Erixon Anaya, R. NCS T. Payam Andalib Jalal Atieh Lisa Bailey Matthew Bailey Lauren Baker, RPSGT Alicia Ballas Marion Banks, R. EEG T. Melinda Barrett Alison Beagley Melissa Bedgood Micael Beebe Susan Bell Thomas Benton, R. EEG T., LPN Jenna Beritsky Jeremi Berta Anya Berube Marissa Biever Rajesh Bindal Julie Birchfield, CNIM, MS Nicholas Birk Steven Bittel, R. EEG T., MBA Brandon Blaylock James Blaylock, CNIM, DC Coreen Bobbette Aleshia Bolton Jessica Bond, R. EEG T. Rachelle Bonifer Mitali Bose Jeremy Bouchard Teresa Bove, R. EEG T. Shayna Bowman Sandra Boyd, R. EEG T. Jennifer Brandon Dana Bratka Jordan Breckinridge, CNIM Gruendolyn Bridges Barry Brisco, R. EEG T. James Brooks, CNIM, RPSGT Megan Brower, DC Angela Brown Deborah Brunelle Amy Bryan Deborah Bufford Peter Buhay, R. NCS T. Benjamin Burdon, CNIM Michele Buschkotter Erica Bustamante Jaime Buzo Sean Cahill Kathleen Carlson Cathy Carman Craig Carroll, DABNM, DO Emily Chapman Jean Charbonnet Valerie Chavez Kristel Cheney Meaghan Christian Allen Chu Beth Clark Robert Clarke, PhD Travis Clem Kelli Cobert Debra Coppock, LPN Jackie Corrao Gary Cosmo, R. EEG T. Cathleen Crawford, R. EEG/EP T. Gwen Cressman, RN Catherine Critz Jataesha Crump, R. EEG T. Herminio Cuervo Delgado Tony Cuff David Cullum, RPSGT, RRT Lana Curl, R. EEG T., RPSGT Susan Curlett, CCT Jamie Curry, R. EEG T., CNIM, MBA, PhD Cartez Davis Martin De La Huerta, R. EEG T. Dana Dean J Michael Dennis, CNIM Julia Dillon Jon Jon Dizon, MEd Paul Domer, R. EEG/EP T. Noemi Dones MARCH 2009 • Volume 33, Number 1 Diane Douglas, R. EEG T. Wayne Douglass, R. EP T., CNIM Alexander Dubashinsky Lauren Dunham Anna Dynowska, MD Caroldea Eggleston William Ellis, R. EEG/EP T. Gourilavanya Eswara Rita Fawcett Scott Fedorek, R. EP T., CNIM, R. NCS T. Eva Fis Tracy Fondren Joann Forsman Kasey Fox, CNIM Christy Franklin Dana Frantz Bryan Fulmer, CNIM Pamela Gage Vivienne Gaither Kathleen Gallagher Ivan Galvez Rudy Garza, LVN Stephanie Gates, RPSGT Cindy Gehlman, LPN Mark George, CNIM Patrick Georges Matthew Geter Robyn Getz, RN, CNRN Forough Ghahramani Lacey Gibbons, CNIM Danielle Gill Deedra Gillis Danielle Givens Linda Gjurich, LPN Ivelis Gonzales Daniel Gonzalez Maria Gonzalez Rolando Gonzalez Mark Goodlet, RT Angela Goracke Lori Gordon, R. EEG T., CLTM Don Grace, R. NCS T. Misty Green, CNIM Tierra Griffin Andrea Griswell Julie Gromoll Carrie Groo Colleen Guerriere Laura Guido, RRT, CPFT Kristy Gulick William Gulledge Phillip Hagan Catherine Hageman, CRTT Nicholas Halcomb, CNIM Nichole Halstenrud Rick Hamad, R. EEG/EP T., CNIM William Hammer Kathryn Hart, RN, MBA Justin Hawkins, RN Kathleen Hays, R. EEG T. Tina Heddens, RPSGT Stacey Helderman Margaret Herlocher-Nathe, R. EP T. Loriann Hernandez Martina Higgs, R. EEG T. Jenna Hildebran Lisa Hill Judi Hillers Brad Hodgeman Sara Hodson Jeanne Hogan Heather Holcomb, R. EEG T. Christopher Holt, R. EEG T. Anthony Horton Jie Huang, CNIM, MD Kerri Hudson Antonino Incorvaia Valerie Jaramillo, R. NCS T. Craig Johnson Micheal Johnson Silvia Johnson, R. EEG T. Audrey Johnson-Correll, R. EEG T. Joanne Johnston, R. EEG T. Robin Jones, CST Stephanie Jordan, R. EEG T., CNIM George Joseph Nancy Juszczak, R. EEG T. Maya Karshenboyem, CNIM, MD Corrina Kater, RPSGT Catherine Kay Donna Kebbel, R. EEG T. Bryan Kehoe Amanda Kelley, CNIM Valerie Kelley, RN Erin Kellog, RPSGT Ryan Kimberly, LPN Genevieve Klutz Silvia Kozlik Maureen Kruse Deepak Lachhwani Aimee Lamerson Derek Lancaster, CNIM, RPSGT, RRT Nakia Langley, R. EEG T. Margaret Lavoie, R. EEG T., RPSGT Continued on page 8 왘 ASETnews 7 MEMBERSHIP NEWS & SERVICES continued Congratulations to Our New Members Continued from Page 7 Deborah Leal, R. EEG T. Earl Leatherwood John Lee, RPSGT, RRT Denise Lehew, RN, CNRN Douglas Leigh Muriel Lerner, R. EEG/EP T. Jonathan Levy Yunxia Li, R. EEG T. Brandon Lichtman, FAAA Evette Licon Deborah Light, R. EEG T. Michael Lillard Debra Livingston Jill Loli, CNIM Ryan Londot, CNIM Betty Long John Lott Judith Loviska, RPSGT Challa Lowry Jessica Lueth, R. EEG T. Jennifer Lundstrom Steven Madrid Leslie Malkin-Gosdin, R. EEG/EP T. Tara Marchesani Daniel Marko Yashica Marshall, MS Mary Ellen Masciale Beth Masny Judy Masterson Christine Mastin Sandra Mathias, R. EEG T., RPSGT Mark Matibag, R. EP T., CNIM Matthew Mauldin Bryan McCormick Shaun McCrae, DC Angela McElderry Adrienne McGill Carroll McGorkey Mary McKinstry Michael McManus K. Mario McNeill Martha Mehdipour Steve Mendehall, R. EEG/EP T. Bonnie Merkel, R. EEG T. Karleton Merz, R. EEG T. Melissa Messier Vanessa Metcalf Christine Miller, R. EEG T. Phillip Miller, CNIM Adele Mirabella, R. EEG T. Miller Miranda Ronald Montgomery Charlotte Moore, DABNM, PhD Beth Moorman Lisa Morris Michael Morrissey, RPSGT, PhD Nicole Moss, CNIM, MS Rachel Murry Kenneth Nay, RPSGT Nona Nazemzadeh-Vaziri Angelica Nguyen Kevin Nguyen Ryan Nider Tina Nist Kylie Nystrom Dell Oakes, R. EEG T. Barbara Ochs John O'Renick Richard O'Rourke Daniel Osei-Bonsu, CNIM Haytham Osman Mary Ovrebo, RRT Carissa Padgett, R. EEG T. Sophia Pa-Hin Pamela Parks, R. EEG T. Ronny Pasley Chris Pearson, R. EEG T. Roger Pennington Sandra Perotti Shannon Pierson, R. EEG T. Elizabeth Pinkhasov, PhD Ignacio Pita Deborah Pittman, R. EEG T. Nathan Pittman Lori Plazek Mary Pomer Eleanor Porneso, R. EEG T. Don Potter, R. EEG T. Bryan Potts Jennifer Powell, DC David Powner Ravinesh Prasad, R. EEG T. Julie Predmore-Fossum, R. EEG T. Scott Pressley Amanda Pruismann, R. EEG T., CLTM Karen Pruyne, R. EEG T., CNIM Kimberly Pullen Ben Quinn Kate Quinn Karen Rama Anthony Ramirez Moises Ramirez Arleise Ramos, R. EEG T. Karen Ramos Janet Randolph, R. EEG T. Michael Raymond Bryant Reed Renee Repenn Jeffrey Reznic, CNIM MARCH 2009 • Volume 33, Number 1 Lacey Rhames Kristin Rich Michelle Rieman Zachery Riemer Danny Rigamonti, CNIM Mary Riggs Marlyn Risko, CRET Barbara Rizk, R. EEG/EP T., CNIM Megan Roberts Elizabeth Rosback Cali Rose Teresa Ross, R. EEG T. Jim Roxburgh Maurice Ruggs Susan Rush, CNIM, CCC-A Alvaro Salazar Gregory Sambuchi Arturo Sanchez, CNIM, R. NCS T., MEd Patricia Schmidt, R. EEG T. Lisa Schultz Teal Schultz Laurie Scukanec Deivra Sears Shelly Selby Onile Sestokas Rajiv Sharma Rachael Sharp John Shaughnessy Gloria Sherin Minakshi Shukla Noemia Silva Nirmal Singh, CNIM, DABNM, MS Gregory Slack Jadwiga Slusarski Rhonda Sly Diane Smith James Smith, R. EEG T., R. NCS T. Synda Snider Ezra Snyder, CNIM Jodi Spaulding, R. EEG T., CLTM Hollie Spears Luvenia Spencer, CCT Leshia Squires Justin Srygler, RRT, RPFT Marcell Staples, R. EEG T. Barbara Stark Jessica Steadman, RPSGT Audrey Steele, CNA Ben Stiling Eugene Stubbs Muni Subramani Rita Sullivan, R. EEG/EP T. Catherine Swanson, ALAS Jessica Swehla Jennifer Swider, CNIM, MA Tracy Tackett, R. EEG T., CNIM Kerry Tamone Penny Taylor, R. EEG T. Lena Teacle, CST Gabriel Thomas, DC Amanda Thompson, RN, BSN, MHA Kennith Thuok Cynthia Thweatt Daniel Tillery, R. EEG T., R. NCS T. Fabian Torres Henry Torrico, R. EP T. Mallory Tosches Pallavi Trivedi Debra Tryggestad, R. EEG T. Andrea Tucker Carlita Tucker Vincent Tufaro Leah Tvedt Christi Updike, R. EEG T. Elizabeth Vader Kelli Veilleux, R. EEG T. Susan Vergara, MEd Deann Vestal Kevin Vinecore Scott Volland, R. EEG T. Armani Voss Amy Wade Jennifer Wagner Pawel Walczak, CNIM, DABNM Britt Wallace, R. NCS T. Qiang Wang Marcie Warner, R. EEG T. Amanda Washington John Wayert Bonnie Webster Christopher Weidler Matthew Weyhe Bryan Wheeler, R. EEG T., CNIM Grace Whistler, RPSGT Lesley Wiehle, R. EEG T. William Wilent, CNIM James Wilkinson, MD Angela Williams Shulisa Williams, CNIM, CLTM Michael Windom, R. EP T., CNIM Rima Woo Andrew Xiaohua Xu, CNIM, PhD, MD Amy Yeo Bryan Yohananov Alessandro Zalaffi, MD Kathy Zhu, BS, MS Teresa Zollman ASETnews 8 ASET FOUNDATION Foundation Spotlight John Knott Educational Lecture Program A s a young psychologist, John R. Knott, Ph.D., became confronted with the new method of EEG in the 1930s, influenced by his mentor L.E. Travis. As told by Ernst Niedermeyer, M.D., “Soon he stood on his own feet, constantly striving for better technology and greater understanding of the frequency components of EEG and, in particular, of its development in the course of human maturation. As a radio amateur since adolescence, his interest in electronics was not limited to biological amplifiers. He remained faithful to his old hobby until the very last period of his life. In this manner, he became a veritable wizard in the world of oscillators and amplifiers. This phenomenal technical know-how was just the basis of his comprehension of the EEG phenomena. The EEG signal, its polarity and propagation, was the cornerstone of his edifice of EEG comprehension.” Dr. Knott created the EEG Laboratory at the University of Iowa in 1939, one of the first in the nation. In so doing, he was instrumental in developing, and later defining, the position of EEG technician/technologists that we have inherited. Dr. Knott led and shaped the electroneurodiagnostics profession in ASET Foundation Donors The ASET Foundation gratefully acknowledges donors who have made contributions since November 2008. Thank you for your continued support of ASET and the ASET Foundation. many ways through countless hours of dedicated scientific endeavors in electroencephalography and in service to EEG technology. Dr. Knott worked throughout his career for the betterment of EEG technologists. He was co-editor of the American Journal of EEG Technology from 1966 through 1973. He served as member and chair of the Joint Review Committee on Education in EEG Technology (JRC/EEG). He co-authored Fundamentals of EEG Technology. He was the moving force behind the formation of ABRET, traveling across the entire United States, organizing regional examinations and convincing technologists that, through ABRET, there was a road to increased professional status. Educator, employer, ABRET organizer, author, and clinical electroencephalographer, Dr. Knott died at the age of 81 years. Originally conceived by Albert Grass and John Knott, the John Knott Educational Lecture program is a lecture series designed to bring distinguished speakers to an area society meeting, thereby providing exceptional educational opportunities for technologists who might Melba Addison Jose Arvizu Alberto Balmaseda Walter Banoczi Yvonne Bassett Kay Bechel Marc Beezy Olga Belyakina Lisa Bennett David Betts Richard Brenner Dianne Budzyn Pablo Caballero Kathy Caplan Brinda Cobb Cathy Cross Sunday Dale MARCH 2009 • Volume 33, Number 1 Elamir Elsherif Marie Erickson Debby Ferguson Janice Fletcher Michele GalganskiCleanthous Janet Ghigo Cynthia Ghunney Constance Gilbert Roy Gilbert Martha Glandon Ignacio Gonzalez Penelope Groom Leah Hanson John Allan Hardy Margaret Hawkins Ghada Hobbs be unable to attend the national meetings. Local, state, and regional societies representing the interests of electroneurodiagnostic technologists are eligible for the opportunity to host a Knott Lecturer. To be considered to host a Knott Lecturer, the society must complete the Request for Lecturer form in full and return to the ASET Foundation. Local, state and small regional societies will receive consideration over the large regional groups who can better attract experienced speakers. Selection also will be based on the order in which applications are received; how recently the society has hosted a Knott Lecturer; and the information presented in the Request for Lecturer application. Three choices for topics to be presented should be specified on the form. The expected attendance for the meeting should be 30 or greater. A minimum of 45 minutes should be allowed for the presentation. The lecturer’s presentation should be delivered to the largest gathering of participants, i.e., to the general session, and not a smaller discussion or workshop group. If workshops or open discussion Michelle Holfester Major Suzette Izac Janet James Dirk Kancilia Christine Kratsas Connie Kubiak Cynthia Major Brian Markley Deborah Mason Laurette Mets William Mills Robert Moody Grace Nde Sherry Nehamkin Sean O'Connell Kathleen Okoneski Patrick O'Leary Continued on page 10 왘 Claire Peranteau Cheryl Plummer Giselle Rackley Mark Ryland Marlene Sablan Alefel Salegio Louise Simms Leshia Squires Victoria Stanich Debra Tryggestad Karina Vaudenay Jeanne Yoshina Natalia Zarzhitsky ASETnews 9 ASET FOUNDATION continued Please Support the Fifth Annual Silent Auction Foundation Spotlight Continued from Page 9 P reparations are now underway for the ASET Foundation’s fifth annual silent auction. The event will be held at the ASET 50th Anniversary Annual Conference, August 5-8, 2009, in Phoenix, AZ. Items for the silent auction will be on display in the annual conference exhibit hall. Bidding will open at the Exhibit Hall Opening Reception on Wednesday evening, August 5, and continue during exhibit hall hours through the Friday morning coffee break in the exhibit hall. Then, auction items will be moved to the lunch room on Friday where conferees will have a final 30-minutes to participate in a bidding frenzy. The silent auction will be closed-out – and funds collected – during the Friday conference lunch from 12:30 p.m. to 1:30 p.m. The ASET Foundation supports educational initiatives, programs, and special projects designed to advance and support excellence in quality patient care by providing resources to electroneurodiagnostic students and professionals to enhance knowledge, understanding, and skills in the field. The Foundation’s silent auction is its largest annual fundraising event. Now more than ever we need your help and generosity to make this event successful. Please consider donating one or more items for the auction. Past popular items have included gift baskets, DVD players, iPods, digital cameras, original artwork, handmade afghans and quilts, and the like. To make a donation, simply complete the form below or visit the Foundation tab on the ASET website to download and print the form. All donations to the Foundation’s silent auction, and all contributions, are tax deductible from your income in the year they are donated. Emphasis from all proceeds from the silent auction will be placed on the ASET Scholarship Fund, Curriculum Development Fund, and general operating costs, followed by supplemental funding of the Foundation’s named funds. 쎲 are planned, the lecturer may be considered for participation in addition to his or her lecture. The John Knott Educational Lecturer program is supported by interest earned on a restricted fund as well as by member contributions to the fund. The ASET Foundation is responsible for the fund management and annual selection of the host society. The ASET Foundation covers the costs of hotel, travel, and meal expenses incurred by the lecturer, duplication of handout materials, and a lecturer honorarium. The Foundation supports one lecture presentation within its fiscal year. For the Foundation’s fiscal year beginning July 1, 2009, the deadline for submitting a completed Request for Lecturer form is July 1, 2009. For more information on the John Knott Educational Lecture program and to request an application, please contact Faye Mc Nall, ASET Director of Education. 쎲 SILENT AUCTION DONATION FORM The fifth annual silent auction, held in conjunction with the ASET 50th Anniversary Annual Conference, August 5-8, Phoenix, AZ, is designed to raise money to support the Foundation’s scholarship and educational programming efforts. The ASET Foundation is a 501(c)3 organization (Fed. ID #770644963) and donations are tax deductible. Complete this form in its entirety, including the signature, and return to the ASET Executive Office no later than July 15, 2009. If you are donating more than one item, please copy this form and return one form per item. The item is [please check one]: Name ________________________________________________________________________ Company/Institution _____________________________________________________________ 쏔 쏔 Address ______________________________________________________________________ Phone ________________________________________________________________________ Email ________________________________________________________________________ Included with this form. Will be mailed/shipped to the ASET Foundation office for receipt no later than July 15, 2009. [Mail to: 6501 East Commerce Avenue, Suite 120, Kansas City, MO 64120] 쏔 Will bring to the ASET Annual Conference in Phoenix, AZ. [must have on site by August 5, 2009] Item to be donated ______________________________________________________________ I do hereby agree to donate the item stated _____________________________________________________________________________ above to the ASET Foundation’s silent auction. Estimated Retail Value $________________ Signature _____________________________________ Description of Item: [Please be as complete as possible, note any restrictions of use or other information that will be helpful to a bidder. This information will be used in the auction catalogue and other listings.] _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ MARCH 2009 • Volume 33, Number 1 Date _________________________________________ Return this form to: ASET FOUNDATION, 6501 East Commerce Avenue, Suite 120 Kansas City, MO 64120 816.931.1120 phone • 816.931.1145 fax ASETnews 10 EDUCATION & PROFESSIONAL DEVELOPMENT Department of Education Report Submitted by Faye Mc Nall, R. EEG T., MEd ASET Sets the Gold Standard W ith the current economic crisis, you may have seen a reference to the term “Gold Standard”. While listening to NPR the other day, I heard an explanation of the origin of this term. When talking about currency, it means that paper money is backed by an exact amount of gold. The USA had a gold standard until 1968. ASET has its own “Gold Standard”. That is to support technologists by offering the highest quality education. We set the standard very high, to ensure that when you attend an ASET course, you will get comprehensive, up-to-date information. We have lived by this gold standard for fifty years, and we have reason to celebrate. 2009 is filled with golden opportunities for you. Check out our Spring Seminar Courses, hosted by the world-renowned Cleveland Clinic, to read about the details of these courses CLICK HERE. I have been working with the ASET 2009 Program Committee and five Course Directors, to plan the General Session and Annual Courses for our Golden Anniversary celebration in Phoenix. The local medical community in Phoenix has been absolutely wonderful to work with, and many area physicians and technologists have offered to speak, or have networked with me to cover a specific topic. It has truly been a gold mine of talent! You will see details of the annual conference in this newsletter, but like a proud parent, I must boast about a few of the meeting highlights! • The 2009 Annual Symposium – “The Emerging State of Emergency END”: As new treatments for neurological disorders emerge, neurodiagnostics have become an integral part of urgent patient care. In the E.R., O.R., ICU, and now in the Interventional Radiology Suite for treatment of strokes, you will find END Technologists on-duty at any time of the day or night. This symposium will address the challenges of emergency coverage. • EEG Key Topics – “Hypotermia Protocol for Neonates” This lecture will address another use for urgent EEG monitoring. • Trends in END Technology – “Prion Disease Update” Learn more about types of Creutzfeldt Jakob and “mad cow” disease! Find out the latest recommendations to prevent spread of these deadly diseases. • Advanced IONM – “MEPs and SSEPs in Pediatric Spinal Surgery” - Dr. Jarrar will discuss special techniques and protocols to optimize recording MEPs and SSEPs for pediatric patients during corrective spinal surgery. • LTM/Epilepsy – “Surgical Treatment for Epilepsy: Case Studies, an Interactive Workshop” This will be an excellent opportunity for anyone planning to take the CLTM exam! • Professional Development – “Marketing your END Lab/Service” – When patients and doctors can choose which facility to use for diagnostic services, it is essential that you market your END lab or monitoring service and get “name recognition”. • Evoked Potentials and NCS Courses – We will offer hands-on workshops in both of these courses, with small groups, expert facilitators and ample opportunity to pick up new skills. 쎲 MARCH 2009 • Volume 33, Number 1 Long-Term Monitoring Publications; Revised and Updated Long-Term Epilepsy Monitoring: How to Set Up and Maintain a Unit: Second Edition 2009; 185 pages Valuable information that will help you set up and run a long-term epilepsy monitoring unit is found in this publication. Three new articles are included in the Second Edition including the ACNS Guideline Twelve: Guidelines for Long-Term Monitoring for Epilepsy and the Infection Control: 2008 Review and Update for Electroneurodiagnostic Technologists. Some of the topics covered include: • recording equipment, video and computer components, networking and archiving options, • staffing and technical competencies for LTME, • Phase I presurgical protocols, and • Phase II epilepsy surgery protocols. Long-Term Epilepsy Monitoring: Clinical, Electrographic and Radiological Findings: Second Edition 2009; 181 pages The highly varied, amazing clinical, EEG, and radiological findings seen during LTME are described in this book. Five new articles are included in the Second Edition. Topics include: • EEG findings in adult and pediatric seizure disorders, • seizure semiology, • Wada testing, • vagal nerve stimulation, • reflex epilepsy, • cognitive testing during seizures, and • psychogenic nonepileptic seizures. 쎲 ASETnews 11 EDUCATION & PROFESSIONAL DEVELOPMENT continued And the Award Goes To… 2008 Kathy Mears Education Award M any of you are familiar with the Kathy Mears Memorial Lecture, which makes it possible for us to bring a highly respected END Technologist to give a presentation during the Annual Conference General Session. But did you know that we also have a Kathy Mears Education Award? Kathy was a past-president of ASET and ABRET, and was also an enthusiastic mentor and Amanda Clements and the McLennan Community College END educator for END technologists. Technology Program were awarded the 2008 Kathy Mears In memory of her dedication to Education Award. educational endeavors in our field, this award supports END Programs and outstanding students. END Technology programs that are accredited by CAAHEP are eligible to apply for this award, which provides $500 to the recipient selected by the K. Mears Award Committee. The award is divided, and a $300 scholarship goes to the student who is nominated by the Program Director. The student selection is based on academic achievement and leadership and volunteerism efforts, with a lesser emphasis on financial need. The remaining $200 is awarded to the END School to fund the purchase of an item that will contribute to the success of the Program and benefit the students and faculty. Congratulations to Amanda Clements, and the McLennan Community College END Technology Program, as recipients of the 2008 Kathy Mears Education Award. Amanda is President of the END/PSG Club at the college. She has personally encouraged each of the new students to join and participate in the club, and has conducted fundraising to establish an endowed scholarship for her END Program. Mary Feltman, her Program Director, will use the award to purchase ASET conference call CDs on a variety of topics, to enhance their library of study resources. 쎲 Indianapolis Making Great Strides in Field of END T he Clarian Health END Technology program in Indianapolis, Indiana started its first class in March of 2000. They have graduated five classes so far with 100% of the graduates successfully achieving R. EEG T. and 75% are double or more boarded. The school was initially CAAHEP accredited in EEG and EP. Debby Ferguson, Program Director, has announced that as of January 2009, they are now accredited in EEG, EP, PSG and NCS. This has made them the first END program in the country to be accredited in four specialties! They are also the first and ONLY accredited nerve conduction study program in the country! Congratulations to the staff, students and graduates of Clarian Health! Indianapolis also boasts three ABRET accredited END labs, which is more than any other city in the country! These hospitals include Clarian Health’s Indiana University Medical Center and Riley Hospital for Children, Clarian Health’s Methodist Hospital and St. Vincent’s Hospital. Indianapolis is sure to be the place to go for END! 쎲 MARCH 2009 • Volume 33, Number 1 ASET 2009 2nd Quarter Webinar Lecture Series Schedule APRIL April 1st Brachial Plexus Anatomy and NCS Testing with Case Studies” by Melody Kise, R. NCS T. April 8th MEG: Magnetoencephalography by Susan Bowyer, MD April 22nd Event Monitoring in the ICU by Stephan Schuele, MD April 29th SUDEP - Sudden Unexpected Death in Epilepsy by Robert Bonsetsch, MD MAY May is “STROKE MONTH” May 6th Special Extended Full-Day Webinar: Evoked Potentials by Selected Faculty May 13th Monitoring the Recurrent Laryngeal Nerve TBA May 20th IONM Using Motor Evoked Potentials by Alan Legatt, MD, PhD Wednesdays at: 12 noon central time 1:00 p.m. eastern time 11:00 a.m. mountain time 10:00 a.m. pacific time ASETnews 12 EDUCATION & PROFESSIONAL DEVELOPMENT continued Request for 2009 Theda Sannit Outstanding Educator Award Recommendations T his award is presented each year to an individual whose contribution to the education of END technologists is worthy of special recognition. It is time for ASET to select the recipient of this award for 2009. We would appreciate recommendations from members to aid us in the selection process. Please keep in mind that this educator must have made contributions on a national level, rather than just locally. ASET staff members are not eligible for the award, and this award may be bestowed on an individual only once. Eligibility and Selection Criteria for the Outstanding Educator The educator may be a technologist or physician with the following: • A minimum of five years experience in END • Professional contributions in the areas of publications, teaching/training, and/or educational development • Demonstration of educational expertise in both national and regional society involvement, such as directing programs, providing instruction, and creating training materials • Teaching experience in a formal END program is desirable. To recommend a candidate, please send the Award Committee the name of the person with a brief note stating the reason for your recommendation. The deadline for submitting recommendations is April 30th. Please send your recommendation to Jie Zhang, committee chair, at [email protected]. The committee will review those recommended and present a list of names to the ASET Board of Trustees for a vote. The award is given to the chosen recipient at the annual conference. Theda Sannit was the first recipient of this award in 1990. ASET has presented the award to the following educators in the subsequent years: 1992 1993 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 . . . . . . . . . . . .Margaret Gordon, R. EEG T. . . . . . . . . . . . .Larry Head, R. EEG/EP T., CNIM, RPSGT . . . . . . . . . . . .Kathleen Mears, R. EEG/EP T. (posthumously) . . . . . . . . . . . .Lewis Kull, R. EEG/EP T. . . . . . . . . . . . .Andrea Erwin, R. EP T., CNIM . . . . . . . . . . . .Patti Baumgartner, R. EEG/EP T., CNIM . . . . . . . . . . . .Lucy Sullivan, R. EEG T. . . . . . . . . . . . .Clay Pollert, R. EEG T. . . . . . . . . . . . .Jean Wilkins Farley, MA, R. EEG T. . . . . . . . . . . . .Walt Banoczi, R. EEG/EP T., CNIM, RPSGT . . . . . . . . . . . .Margaret Walcoff, MEd, R. EEG/EP T., CNIM . . . . . . . . . . . .Ernst Niedermeyer, MD . . . . . . . . . . . .Becky Meng, R. EEG/EP T. . . . . . . . . . . . .Maureen Bendyna, R. EEG/EP T., RPSGT, CNIM . . . . . . . . . . . .Janice Walbert, R. EEG/EP T. . . . . . . . . . . . .Jerry Morris, MS, R. NCS T. MARCH 2009 • Volume 33, Number 1 IONM 100 Neuroanatomy and Neurophysiology ASET On-line Course Review By Sabrina Faust, R. EEG/EP T., CNIM I have always enjoyed case study presentations at meetings and the opportunity to gain a deeper, functional understanding of neuroanatomy through clinical case studies really appealed to me. IONM 100 - Neuroanatomy and Neurophysiology is a 14 week on-line course taught by Dr. Donald York, which is offered by ASET. This course uses the textbook “Neuroanatomy Through Clinical Cases” by Hal Blumenfield, MD, PhD, Sinauer Associates, Inc, 2002 edition that you will need to acquire prior to starting the class. The course consists of weekly assignments that cover one to three chapters at a time, and a question and answer assignment along with a weekly group discussion. In this discussion group, you choose one question/answer from the week to discuss with the group. This course covers the general H&P exam, Sensory and Motor function of the cerebral cortex and pathways, the neurologic exam in full, spinal nerve roots, Cranial Nerves, Vascular Supply, Neuroradiology, and higher-order cerebral function. The textbook has some of the best anatomy illustrations I have seen and gives periodic mnemonics throughout. Whether you are new to the END field, studying for boards, entering the IONM field or just want a good refresher or better understanding of Neuroanatomy and Neurophysiology at its best, this class is for you. Ever wanted to know more about MRIs, CTs, Xrays and Angiograms? This book covers it! 쎲 ASETnews 13 TECH TIPS Multidrug-Resistant Organisms By Lucy Sullivan, R. EEG T., CLTM M ultidrug-resistant organisms (MDROs) are microorganisms, predominantly bacteria, that are resistant to one or more classes of antimicrobial agents. New MDROs continue to emerge. Following is a list of some of the most common MDROs: • Methicillin-resistant Staphylococcus aureus (MRSA) • Vancomycin-resistant enterococci (VRE) • Multidrug-resistant Gram-negative bacilli • Penicillin-resistant Streptococcus pneumoniae (PRSP) • Vancomycin-resistant Staphylococcus aureus (VRSA) • Multidrug-resistant M. tuberculosis (MDR TB) • Extensively drug resistant M. tuberculosis (XDR TB) An antimicrobial is a substance that kills or inhibits the growth of microbes such as bacteria, fungi, or viruses. Since most of the MDROs are bacterial infections, the drug resistance is to an antibiotic. A broad-spectrum antibiotic acts against a wide range of disease-causing bacteria and acts against both Grampositive and Gram-negative bacteria. A narrow-spectrum antibiotic is effective against only specific families of bacteria. Why have MDROs appeared and why do they continue to mutate/evolve? One of the major reasons is that improper use and overuse of antibiotics have lead to the evolution of tougher strains of bacteria. Physicians prescribe antibiotics when they are not needed. Broad-spectrum antibiotics are used when narrowspectrum antibiotics are more appropriate. Patients demand antibiotics for every infection, whether they need them or not. An antibiotic is ineffective against a viral infection. Stopping antibiotics too early kills the weak microorganisms, leaving the strong to develop resistance, flourish, and perhaps spread through the community. Other reasons for the MDRO invasion are illnesses for which antibiotics are prescribed, such as childhood ear infections and sinus infections, are on the rise. Global travel is quickly and widely transferring multidrug-resistant organisms. The increased use of invasive devices (dialysis and urinary catheters, endotracheal tubes, central lines) in patients is providing easier access routes for MDROs. Increasing numbers of hospitalized patients have weakened immune systems due to chemotherapy, HIV, and immunosuppresants. Repeated contact with the healthcare system is a major risk factor for acquiring a MDRO. Options for treating patients with MDROs are extremely limited. Increased lengths of stay, costs, and mortality have been linked to MDROs. Colonization is when the organism is present in or on the body but is not causing illness. Many of us are colonized with MRSA but since we have intact skin and are healthy, we do not have an active infection. Infection is when the organism is present and is causing illness. MARCH 2009 • Volume 33, Number 1 Good hand hygiene is the primary prevention measure for preventing the spread of MDROs. Standard Precautions should be used and Contract Precautions are recommended for patients with MRSA and VRE. The colonized or infected patient should be placed in a single room, if possible, or in a room with a patient who is colonized or infected with the same organism. Active surveillance cultures are performed until the patient is culturenegative for the MDRO. Accurate diagnosis of infectious etiologies is essential and leads to judicious antimicrobial selection and utilization. For instance, a broad-spectrum antibiotic may be used at admission but once the bacterium causing the infection is identified, a narrow-spectrum antibiotic can be prescribed. Improvement in communication about patients with MDROs within and between healthcare facilities is key in slowing down and eventually stopping the spread of MDROs. Methicillin-resistant Staphylococcus aureus (MRSA) was first isolated in US in 1968. In 1974, MRSA was 2% of the total number of staph infections, in 1995 22%, and in 2004 MRSA was 63% of the total number of staph infections. Community-associated MRSA (CA-MRSA) are new strains of MRSA in the community found in people without risk factors. The CA-MRSA is a different strain of MRSA than the MRSA seen in hospitals. CA-MRSA presents most commonly as minor skin and soft tissue infections such as pimples or boils. It can be passed on by sharing towels, clothing, and athletic equipment and has been reported among football and wrestling teams. CAMRSA has caused severe invasive disease including necrotizing pneumonia, necrotizing fasciitis, severe osteomyelitis, and a sepsis syndrome with increased mortality has been described in children and adults. To prevent community-associated MRSA, practice good hand hygiene which includes carrying a bottle of hand sanitizer Continued on page 15 왘 ASETnews 14 TECH TIPS continued Multidrug-Resistant Organisms Continued from page 14 with at least 62% alcohol, keep your personal items personal, keep cuts and abrasions clean and covered, shower after athletic games or practices, and use antibiotics appropriately. Vancomycin-Resistant Enterococci (VRE) is found in the digestive and genital tracts, is normally benign, and doesn’t cause problems in healthy people. VRE is found in hospitals in severely ill patients usually of a very young or old age. Patients with chronic kidney failure and patients with medical devices such as urinary catheters and central lines that stay in for some time are more likely to be adversely affected by VRE. In the United States, VRE has not been found outside of the hospital setting so there is little chance or concern that VRE will become epidemic in healthy populations. VRE has been cultured off hospital equipment, door knobs, bedrails, and the hands of hospital personnel. VRE has been found after 5 seconds of handwashing so at least 15 seconds of handwashing is recommended. Review your hospital’s/facility’s infection control policies and procedures regarding MDROs. “No data are available that show antibiotic-resistant bacteria are less sensitive to the liquid chemical germicides than antibiotic-sensitive bacteria at currently used germicide contact conditions and concentrations” (Rutala and Weber 2008). Remember that MDRO colonization is difficult to detect so treat all electrodes as potentially contaminated by a MDRO and also by blood (Bild 1997). Antiseptic/soap are germicides applied to living tissue and skin. Detergents and disinfectants are applied to inanimate objects. Disinfectants are not used on the skin because they can injure skin and other tissue. And the soap in the sink dispenser is made for your hands, not to disinfect your electrodes. MRSA and VRE live on environmental surfaces such as EEG electrodes, electrode wires, and the keyboard on the EEG instrument. “…maximum effective disinfection and sterilization results from first cleaning and removing organic materials and inorganic materials…” (Rutala and Weber 2008). So scrub your electrodes to remove all debris before placing them in the chemical germicide (whether it is a sodium hypochlorite [bleach] solution or a commercial product). The electrode manufacturer should include disinfection protocols with the labeling instructions. Single-use, disposable scalp EEG electrodes are now available from multiple manufacturers. Contact your Infection Preventionist personnel with any questions. It is estimated 1/3 of the world’s population is infected with Mycobacterium tuberculosis (TB) with nearly 9 million persons developing the disease each year. Close to 2 million people die per year from TB complications. TB occurs predominantly in “resource-limited” countries but also occurs in the US. In 1985 to 1992, the US had a resurgence in TB cases that included a rise in the number of multidrug-resistant TB (MDR TB) cases. MDR TB is TB that is resistant to at least two of the best anti-TB drugs. New drugs were approved in 1994 and 1998 and the incidence of TB in US decreased. MARCH 2009 • Volume 33, Number 1 In 2006 results of a global survey identified extensively drug resistant TB (XDR TB). XDR TB is found in every region of the world including the US, is resistant to first-line and second-line drugs, and raises concerns about the possibility of epidemics of virtually untreatable TB. How did drug resistance to first-line and second-line TB drugs happen? The patients do not complete their full course of treatment. Healthcare providers prescribe the wrong treatment, wrong dose, or length of time for taking the drugs. The drugs are of poor quality. The patients develop active TB disease after having taken TB medication in the past. Infection control for TB is different from MRSA and VRE because TB is transmitted via the air when a person with TB coughs, sneezes, speaks, or sings. TB can float in the air for hours. People who breathe in the air containing TB microorganisms can become infected. Standard Precautions and Airborne Precautions (including negative air pressure room and respiratory protection) must be used. “The prevention and control of MDROs is a national priority – one that requires that all healthcare facilities and agencies assume responsibility” (Siegel et al. 2006). 쎲 REFERENCES: Bild S. Detection of occult blood on EEG surface electrodes. Am J Electroneurodiagnostic Technol 1997; 37:251—57. Rutala WA, Weber DJ. Guideline for disinfection and sterilization in healthcare facilities, 2008. Centers for Disease Control and Prevention. On the Internet at: www.cdc.gov Siegel JD, Rhinehart E, Jackson M, Chiarello L, Healthcare Infection Control Practices Advisory Committee. Management of multidrug-resistant organisms in healthcare settings, 2006. Centers for Disease Control and Prevention. On the Internet at: www.cdc.gov Sullivan LR, Altman CL. Infection control: 2008 review and update for electroneurodiagnostic technologists. Am J Electroneurodiagnostic Technol 2008, 48:140—65. ASETnews 15 ASET 2009 Annual Conference The Gold Standard August 5-8, 2009 Arizona Biltmore Resort & Spa Phoenix, AZ M ake plans now to come to Phoenix, to help us celebrate our 50th Anniversary of the ASET Annual Conference. This promises to be a very special experience! The spectacular location for this event is the Phoenix Biltmore Hotel. This historic property was built in the style of Frank Lloyd Wright, and is on a resort complex that includes eight swimming pools. ASET has always been the “Gold Standard” for education in END Technology, and we will have a special program to commemorate the contributions of many outstanding technologists who made ASET what it is today. Our 2009 Ellen Grass Lecturer is Dr. Keith Chiappa, of Massachusetts General Hospital, and author of the venerated textbook Evoked Potentials in Clinical Medicine. His lecture will be about the latest in ICU EEG monitoring. Course faculty will include technologists and physicians who have a great deal of expertise to share, and an enthusiastic approach to teaching. There will be extended, interactive sessions in each course, and a series of Sundown Seminars in a variety of special interests. You will also experience the history of END Technology in a timeline museum, with pictures, mementos and equipment from years past on display. Come and network with the techs who made such great strides in years past, and with the techs who will be our leaders of tomorrow. Scholarships Available ASET members: Don’t forget full scholarships are available! Go to www.aset.org and click on the Foundation tab to download the scholarship application. The scholarship deadline for the ASET Annual Conference is May 6, 2009. Continued on page 17 왘 REGISTER TODAY to attend the ASET 2009 Annual Conference and be there as we celebrate our golden anniversary! MARCH 2009 • Volume 33, Number 1 ASETnews 16 2009 A NNUAL C ONFERENCE continued ASET 50th Anniversary Annual Conference Schedule of Events Wednesday, August 5th, 2009 5:30 – 5:50 pm Abstract or ASET Updates 1:30 - 1:45 pm Welcome and introductions 6:30 - 8:30 pm Exhibit Hall Opening Reception 1:45 - 2:45 pm Keynote Address – “Talk About It: A Personal Story of Living with Epilepsy” Joyce Bender, Chair-elect of the Epilepsy Foundation 2:50 - 3:10 pm Abstract 3:10 - 3:30 pm Break 3:30 - 3:50 pm Abstract 3:50 - 4:10 pm Abstract 4:10 - 4:30 pm Abstract 4: 30 - 5:30 pm Ellen Grass Lecture – “EEG Monitoring in the ICU” Keith Chiappa, MD Thursday, August 6th, 2009 8:10 - 8:20 am Announcements 8:20 - 8:40 am Abstract 8:40 - 9:00 am Abstract 9:00 - 9:50 am Kathy Mears Memorial Lecture – END: "Let's Get Fired Up" Debby Ferguson, R. EEG/EP T., R. NCS T., RPSGT, MSEd 9:50 – 10:50 am Break in poster area with authors present 10:55 – 11:15 am Abstract 11:40 am - 1: 40 pm ASET Business Meeting & Anniversary/Awards Luncheon 1:45 - 3:30 pm Symposium: The Emerging State of Emergency END 1:45 - 1:50 pm Introductions 1:50 - 2:15 pm EEG in the E.R. Kenneth Jordan, MD 2:15 - 2:40 pm Emergency Utilization in IONM Sherry Nehamkin, R. EEG/EP T., CNIM, CLTM 2:40 - 3:05 pm Treatment of Stroke with SSEP’s Brian Alkire, R. EEG/EP T., CNIM 3:05 - 3:30 pm Panel Discussion 3:30- 4:30 pm Break in poster area with authors present 4:30 - 4:50 pm Abstract 4:50- 5:10 pm Abstract 11:15 – 11:35 am Abstract ASET 2009 Annual Conference Continued from page 16 ASET’s mission is to keep our annual conference affordable and accessible for all attendees. The following prices are for “early bird” registration, with a deadline of July 15, 2009. ASET members: Don’t forget full scholarships are available! Go to www.aset.org and click on the Foundation tab to download a scholarship application, and keep in mind the May 6, 2009 deadline for filing an application! Full 4-days (Wed. – Sat.) Member $500/Non-member $600 2009 Sundown Seminars General Session (Wed. & Thurs.) Member $285/Non-member $360 August 7, 2009 • 5:00 – 6:30 pm Additional registration required - $30 Course Days (Fri. & Sat.) Member $375/Non-member $450 Topics Covered: Q-EEG Workshop CPT Coding Workshop EEG Board Prep Study Tips Workshop CNIM Study Tips Workshop CLTM Study Tips Workshop Registration Fees In addition, spouse/guest registrations are available, as well as some ticketed events. Youth/teens under the age of 18 will not be permitted in the exhibit hall. Continued on page 19 왘 MARCH 2009 • Volume 33, Number 1 August 7, 2007 SUNDOWN SEMINARS: 5:00 – 6:30 p.m. EEG Board Prep Study Tips Workshop TBA . . . . . . . . . . . . . . . . . . . . $30 Q-EEG Workshop (Use in OR and ICU) Jay Gunkleman, QEEGD . . . . . $30 CPT Coding Workshop TBA . . . . . . . . . . . . . . . . . . . . $30 CNIM Study Tips Workshop TBA . . . . . . . . . . . . . . . . . . . . $30 CLTM Study Tips Workshop TBA . . . . . . . . . . . . . . . . . . . . $30 ASETnews 17 ASET 2009 Annual Conference Course Schedule Course Offerings for Friday, August 7th Course Director: Judy Ahn Ewing, R. EEG/EP T., CNIM, CLTM Course Director: Nancy Haferman, R. EEG/EP T., RPSGT Course Director: Erica Seagrave, R. EEG/EP T., CNIM Course Director: Becky Meng, R. EEG/EP T., BA EEG Key Topics Trends in END Technology IONM Key Topics Evoked Potentials 8:00 – 8:50 a.m. The EEG in Head Injury Marc Nuwer, MD Are You Awake? MWT Testing Jane Peasely, R. EEG T., RPSGT EMG in IONM Brett Netherton, MS, CNIM Evoked Potential Instrumentation Larry Head, R. EEG/EP T., RPSGT, CNIM 9:00 – 10:00 a.m. The EEG in Hypothermia Protocol for Neonates Janet Tedori, MD Prion Disease Update: CJD, BSE and Infection Control Patricio Reyes, MD Recurrent Laryngeal Nerve Monitoring TBA Anatomy and Techniques of VEP and BAEP Margaret Walcoff, R. EEG/EP T., CNIM, CLTM, MEd 10:00 – 11:00 a.m. 11:00 – noon Coffee Break – Exhibit Area Nonepileptic Events Mark Natola, R. EEG T. Noon – 1:30 p.m. 1:35 – 3:00 p.m. Remote Monitoring Mark Helderman, R. EEG T., CNIM Anatomy and Techniques of SSEP Jim Higgins, CNIM Lunch/Auction Close Out Name that Pattern! An Interactive Session Larry Head, R. EEG/EP T., RPSGT, CNIM 3:00 – 3:20 p.m. 3:20 – 4:20 p.m. Transcranial Doppler for END Technologists Jeff Balzer, PhD, DABNM, FASNM TCD: Hands-on Workshop Jeff Balzer, PhD, DABNM, FASNM IONM Case Presentations Clare Gale, R. EEG T., CNIM Hands-on Workshop: BAEPs, VEPs, SSEPs Break – Exhibit Area Practical Tips for Electrode Application Yvette Sabel, R. EEG T. Esperanza Wagner, R. EEG T. EEG in the ICU: Rhythmical and Periodic Patterns John Kerrigan, MD Anesthesia and Multimodality Monitoring Tod Sloan, MD Clinical Utility of Evoked Potentials, Present and Future Jonathan Carter, MD Course Offerings for Saturday, August 8th Course Director: Judy Ahn Ewing, R. EEG/EP T., CNIM, CLTM Course Director: Nancy Haferman, R. EEG/EP T., RPSGT Course Director: Erica Seagrave, R. EEG/EP T., CNIM Course Director: Brian Markley, R. EEG/EP T., R. NCS T. LTM/Epilepsy Professional Development Advanced IONM NCS Key Topics 8:00 – 8:50 a.m. Developing the Monitoring Plan: Recording Strategies and Techniques Pat Trudeau, R. EEG T., CLTM How to Use the Briggs Meyers Test to Boost Teamwork Debby Ferguson, R. EEG/EP T., R. NCS T., RPSGT, MSEd Deep Brain Stimulation Chris Harris, CNIM Polyneuropathy Sheila Shelton, R. NCS T., R. EEG/EP T., MEd 9:00 – 10:00 a.m. Quality and Safety Issues in The EMU Joseph Drazkowski, MD Ethics in END – HIPPA, Transparency and Sticky Issues Madona Pluegar, RN BAEPs in the OR Alan Legatt, MD Common Entrapment Neuropathies Janet James, R. EEG T., R. NCS T. 10:00 – 10:20 a.m. Coffee Break 10:20 – 11:20 a.m. Advances in the Treatment of Epilepsy David Labiner, MD Marketing your END/Sleep Lab or Company Elizabeth Mullikin, R. EEG/EP T., CNIM, MPA, MA, MNM MEP/SSEPs in Pediatric Spine Surgery Randa Jarrar, MD Neuromuscular Junction Diseases and Evaluation Jerry Morris, R. NCS T., MS 11:30 a.m. – 12:30 p.m. Functional Anatomy and Neuroimaging Ed Carlson, R. EEG/EP T., CNIM, CLTM How to Choose the Right Equipment for your END/Sleep Lab Lois Wall, R. EEG/EP T. Current Trends in Intraoperative MEPS Jeff Balzer, PhD, DABNM, FASNM NCS/EMG Case Studies Todd Levine, MD Spontaneous & Triggered EMG with Cervical, Thoracic, & Lumbar Spine Surgery Mike Isley, PhD, DABNM, FASNM Hands-on Nerve Conduction Workshops: Basic & Advanced Mark Ryland, R. EP T., RPSGT, R. NCS T., MA Terri Hicks, R. NCS T. 12:30 – 1:30 p.m. 1:40 – 3:10 p.m. Lunch Case Studies in Surgical Treatment for Epilepsy: An Interactive Workshop James Riviello, MD 3:20 – 3:50 p.m. MARCH 2009 • Volume 33, Number 1 The Economic Crisis and the END Field: A Survival Workshop for Technologists Scott Blodgett, R. EEG T., RPSGT Closing Ceremony ASETnews 18 2009 A NNUAL C ONFERENCE ASET 2009 Annual Conference Continued from page 17 continued ASET’s 50th Anniversary Celebration will include Hotel Information END Museum A room block has been set aside at the acclaimed Arizona Biltmore Resort and Spa. Reservations are to be made directly with the hotel before July 13, 2009, to secure the special conference rate of $120, single or double occupancy, per night. Any reservations made after July 13th, will be on a space-available basis, and may not qualify for the conference rate. Room rates are subject to applicable local taxes. Check-in time is 3 pm and checkout is 11 am. Reservations can be made by calling 602.955.6600, tell them you are with the ASET conference to book the negotiated rate. An anchor piece of the festivities will be an END museum. The museum will be an elaborate display of historical equipment, supplies, pictures, and books; showcasing the movement and development of END technology from its very beginning, to present time. To that end, we are soliciting donations and loaned items of historical interest for the museum. Items that we think may be of particular interest include equipment and supplies from years past, (e.g., old electroencephalograph machines, electrodes through the years) as well as text books and instruction manuals, photographs and pictorial records, and the like. Items relating to electroneurodiagnostics that pre-date 1959 also are encouraged. If you have any questions about this project or would like to submit an item, please contact Arlen Reimnitz, ASET Executive Director, at 816.931.1120 or [email protected]. Known as the “Jewel of the Desert,” the Arizona Biltmore Resort & Spa provides an oasis of lush gardens, glistening swimming pools, and Frank Lloyd Wright-influenced architecture. The Arizona Biltmore has been a favorite destination for celebrities and US presidents throughout its colorful history. Timeline Display The hotel features: • 739 guest accommodations • 78 one-and two-bedroom villas • Eight swimming pools • Seven tennis courts • A full-service resort spa, salon and fitness center • Five dining options The adjacent Arizona Biltmore Country Club boasts two 18hole PGA golf courses: The Links and The Adobe. For more information and to make your reservation now, you can contact The Arizona Biltmore Resort & Spa at; 2400 East Missouri Ave Phoenix, AZ 85016 Phone 602.955.6600 www.arizonabiltmore.com 쎲 MARCH 2009 • Volume 33, Number 1 As we celebrate ASET’s 50th Anniversary in 2009, walk through time and see how ASET and END technology have changed over the last 5 decades. ASET’s growth in membership and educational offerings has been a true testament of the continued support we have received from you, our members, and supporting companies. The timeline display will be positioned on 5 display boards and premiered at our 50th Anniversary Annual Conference at the Arizona Biltmore Resort and Spa in Phoenix Arizona, August 5-8, 2009. Tech Stories You can share your stories – funny, inspiring, or sad – from working in electroneurdiagnostics with your peers at the Annual Conference. You have helped shape the END community and we know you have seen it all. Whether it was a strange event that occurred at a previous meeting, or an embarrassing episode that happened at work, or even an unforgettable patient experience, we are interested to hear. You can choose to either present your story in front of a live audience during the General Session or have someone read it aloud for you. We’re looking for recent and distant history here, hoping to capture events through the past five decades. We also welcome any photographs or other images you might be able to contribute. Please send these stories and images to: Patti Baumgartner, R. EEG/EP T., CNIM, ([email protected]). We ask that you limit your stories to no more than 500 words in length and submit them in a simple text format such as Microsoft Word. We ask that photographs and images be submitted in .JPG format. For any questions, call Patti at 913.220.8280. 쎲 ASETnews 19 I NTEREST S ECTION B RIEFINGS Welcome from the Interest Section Coordinator By Margaret Hawkins, R. EEG/EP T., CNIM T he military recognizes the importance of solid knowing and understanding of rules and regulations, procedures and policies, skills and expectations —They call it “Basic Training”…It is rigorous, demanding, stressful and necessary for becoming a good soldier. I asked the Special Interest Section Leaders to take a step “back-to-basics” this month and share some event, technique or concept they learned early on in their careers that has served them well all throughout the years they have been involved in this wonderful field of electroneurodiagnostics. Their stories are entertaining (I could relate to them all!!), insightful, delightful and useful. May we never tire of incorporating the basics into our everyday tasks and of seeing how important they are as building blocks for every new task we take on. ACUTE/CRITICAL CARE END By Patrick O’Leary, R. EEG T., CLTM, RPSGT After working for over thirty-five years in the END field I find that I am still learning. There have been many people who have had a positive influence in my development and I am sure there are more to come. Some of these people especially stick out in my mind as I reflect back over the years. One such person was a neurologist that I worked with in the early 70s at the Philadelphia Naval Hospital. Each morning he would come into the EEG lab to read the previous day’s EEGs. We techs were to write a technical description of each EEG we recorded. We would all sit around the desk and Dr. Brait would read the patient’s reason for referral and then predict what he would find in the EEG. He would then read our technical description while paging through the EEG. If we were accurate in our descriptions, Dr. Brait would buy us coffee. If we were wrong we would have to buy him coffee. He always made learning fun and inspired me to want to know more about EEG and not just to be satisfied with being able to identify artifacts. My desire to want to be able to “read “an EEG beyond its technical quality and actually understand it clinically came from Dr. Brait. Another individual that had a significant influence on my career development was a neurosurgeon at Dartmouth-Hitchcock Medical Center. This was during the late 70s to early 80s when intraoperative neuromonitoring was in its infancy. Dr. Wilson had a particular interest in epilepsy surgery. He was one of the first to perform microsurgical corpus callostomy. Dr. Wilson wanted to know if the EEG showed any significant changes during and immediately after sectioning the last fibers of the corpus callosum. Back then, neurologists didn’t come into the OR with me so I was flying on my own. Prior to the patient’s surgery, Dr. Wilson and I would review the routine EEGs on the patient about to have surgery. These patients almost always had frequent interictal epileptiform discharges and Dr. Wilson would study this activity so as to easily recognize them during the surgery. He was always teaching me, in and out of the OR. Dr. Wilson had passion and confidence in what he was doing and I believe some of this wore off on me. We developed a close friendship and I had immense respect for him. He was gentle, soft-spoken and had great insight. Unfortunately, cancer took him at the early age of 53 in 1983. Since then I have often thought of him and all that he taught me about neurophysiology as well as life in general. AMBULATORY MONITORING By Jennifer Carlile, R. EEG T. Let’s get back to the basics with ambulatory EEG (AEEG). Once the coveted order comes through that an AEEG is needed on a patient, the first thing that needs to be done is schedule the patient. This would be a perfect opportunity to begin educating the patient on what to expect. Many of the physicians and nurses don’t take time to do this. So instead of having the patient anxious of this test, why not explain the basics to them? Explain how long they will wear it, how important it is that they go about their regular daily schedules, how it will be attached, and so forth. Always instruct that they should arrive with clean, product-free hair and that they should wear a button front shirt or one with INTEREST SECTION COORDINATOR Margaret Hawkins, R. EEG/EP T., CNIM Wausau, WI [email protected] INTEREST SECTION LEADERS ACUTE/CRITICAL CARE END Anita Schneider, R. EEG/EP T., CNIM Redlands, CA [email protected] Patrick O’Leary, R. EEG T., RPSGT, CLTM Bangor, ME [email protected] AMBULATORY MONITORING Jennifer Carlile, R. EEG T. Cleveland, OH [email protected] COMPUTERS IN THE WORKPLACE Brian Markley, R. EEG/EP T., R. NCS T., BS Silver Spring, MD [email protected] CPT CODES Lynn Bragg, R. EEG/EP T. Canton, OH [email protected] Kristina Port, R. EEG/EP T., RPSGT, MPH Novelty, OH [email protected] DEPARTMENT MANAGERS Cheryll Poissant, R. EEG/EP T., CAPPM, BS Neenah, WI [email protected] EDUCATION Mark Ryland, R. EP T., RPSGT, R. NCS T., MA Parma, OH [email protected] Mary Feltman, R. EEG T., BS Hewitt, TX [email protected] EPILEPSY MONITORING Cheryl Plummer, R. EEG T. Pittsburgh, PA [email protected] Pat Trudeau, R. EEG T., CLTM Marshfield, WI [email protected] Continued on Page 21 Continued on page 21 왘 MARCH 2009 • Volume 33, Number 1 ASETnews 20 I NTEREST S ECTION B RIEFINGS continued Ambulatory Monitoring. . . Continued from Page 20 Continued from Page 20 a zipper front. Explain why this is so important. Explain how long they will be at this appointment. If they are elderly, recommend that they bring along a family member or friend to assist with any peripheral equipment sent home or just for having a second set of ears to hear the instructions. Once the test is scheduled, send out a reminder notice to the patient with directions to your lab. These little things that are done up front, will just ease the patient’s anxiety and make for a more successful test. With pediatric patients, especially the little ones, I find it helpful to give more details to the parents prior to setting up the child. Letting the children see you interact with their parents on a calm level reassures them all will be okay. Explain if you will be “bundling up” the child with a sheet, similar to a papoose, in order to properly manage their wiggling arms and legs. If the parents appear apprehensive and you have another tech that can assist you, suggest that they go get a cup of coffee and someone will bring them back to the lab after all the leads are in place. Show both the patient and the parents the electrodes. Let them touch them. Show them your tape measure, show how you will use the china marker on their skin, if using collodion, show them the air dryer, let them feel the cool air by their cheek prior to the electrode application. I use this “explanation routine” not only on pediatric patients but all of my patients. Definitely schedule more time for pediatric patients and their parents, since taking more time for instructions and setup will yield a more successful test. Once the electrodes are in place, explain how to use the equipment. Having a printed set of instructions will also ease the patient’s anxiety. I like to recommend that once they are home, to re-read the instructions that we just went over to cement in their brains what is to be expected. Explain the patient diary or the log sheets that need to be filled out and why these are so important to the doctor. Explain when they should come back for removal of equipment, how long that appointment time will be, and what it entails. If they are disconnecting at home, go over those instructions. Again, I find it very helpful to have these printed out for them to take home. Explain what happens when the test is complete, instructing them that they should follow up with their doctor to go over their results. Getting back to basics is simple; just remember how you’d want to be treated when you are having a new test performed on you or your loved one. INTRAOPERATIVE MONITORING Ryan Lau, R. EEG/EP T., CNIM, CLTM, BA Indianapolis, IN [email protected] COMPUTERS IN THE WORKPLACE By Brian Markley, R. EEG/EP T., R. NCS T., BS Back to basics! What does that mean in working with computers? Backup. A fundamental principle of computers is maintaining a duplicate copy of any important data or program. Those of you working in hospital settings with professional IT staff may have this taken care of for you. Even in those settings, there can be some useful things to keep in mind. In any professionally managed network, the servers are backed up frequently. Workstations, on the other hand may not be. This can be an issue if your workstation setup allows information to be stored on the local drives. There is software that can make a complete copy of a system, programs, data, settings, and all. This is referred to as an image. It is the way manufacturers install the operating systems and software on new systems quickly. For recovery from a system failure, this is the best solution. Restoring the image returns the computer to the exact state when the image was made. The latest versions can restore this image even to a different model computer. Restore points are another type of backup that exists in Windows computers. It is sometimes overlooked. You can use a restore point to return system settings to a point when things were working properly. To set a restore point you use the System Restore tool. This is something to be a little careful with if you are not sure what you are doing. When in doubt, get help. (A bonus basic principle) Security. Again in the hospital/corporate environment, this will likely be managed by the IT department with little active role for the users. Still there are a few things to keep in mind. A security element that affects almost everyone is passwords. On our network our security plan requires a “strong” password be used and changed on a scheduled basis. Strong passwords combine any three of the following four kinds of characters: Upper case letters, lower case letters, numerals, and special characters (!#@$%, etc). The reason for using strong passwords is that having many more possible combinations, they are much harder to crack. Passwords should never be shared. Also putting little sticky notes around to remind you of your password is a no-no. Of course you probably hear this all the time in HIPPA training. Anti-Virus. I always get a chuckle whenever I see one of those chain emails describing some dread Eric Isaacson, R. EEG/EP T., CNIM Indianapolis, IN [email protected] NERVE CONDUCTION STUDIES Dorothy J. Gaiter, R. EEG T., R. NCS T., BS Birmingham, AL [email protected] Jerry Morris, R. NCS T., MS Shreveport, LA [email protected] NEW TECHNOLOGIES & RESEARCH Leah Hanson, R. EEG/EP T., AAS New Glarus, WI [email protected] PEDIATRICS AND NEONATOLOGY Shelley Gregory, R. EEG T. Snohomish, WA [email protected] Cale Wilcox, R. EEG T., CLTM Dallas, TX [email protected] POLYSOMNOGRAPHY Kathryn Johnson, R. EEG/EP T., RPSGT Huntington, WV [email protected] Nancy Haferman, R. EEG/EP T., RPSGT Marshfield, WI [email protected] TECHNOLOGISTS WORKING ALONE Sunday Dale, R. EEG/EP T., CNIM, BAS Wichita, KS [email protected] Interest section leaders are a resource to members. Please feel free to contact leaders with questions, problems, suggestions or feedback of any kind. It is the policy of ASET that interest section leaders not promote their services or products through their role within the organization. To prevent misunderstandings, especially for those leaders that must “change hats” when receiving calls at work, please initiate all calls by identifying yourself as calling in regard to ASET’s Interest Section. Continued on page 22 왘 MARCH 2009 • Volume 33, Number 1 ASETnews 21 I NTEREST S ECTION B RIEFINGS continued Computers in the Workplace. . Continued from Page 21 new computer virus. It isn’t that viruses are a laughing matter. It’s just that keeping good anti-virus software installed and updated is the best protection you can have. Actually, the appropriate protection these days is really an Internet Security Suite, which includes anti-spyware, as the types of threats continue to expand. In addition, you should be very careful about files attached to emails, even from folks you know. Lastly, when you are browsing, be very hesitant about letting any website install anything to your computer. As always, questions, comments and suggestions are welcome @ [email protected] CPT CODING By Lynn Bragg, R. EEG/EP T. I live by several undisputed codes. One is a gal can never have too many diamonds and two; one can never have too much knowledge. It is very unnerving for me to hear people complain because they “have” to learn something new for their job. Remember, your employer can make changes in your hours, duties, and even your pay but if they offer you a chance to learn something new, that knowledge cannot be taken away. I know that if I did not have the support from my coworkers and the help from the doctors when I first started in this field, I would never have had been able to pass my boards. I was never ashamed to ask questions or ask for help. It seems today that some think this is a sign of weakness or ignorance. To me it is just the opposite. I would never put a patient or a study at risk just to save face. I know that during my first years in END, the doctors I worked with probably wanted to pull their hair out but I was very persistent until I felt I grasped the concept I needed to understand. When I first started in END, CPT codes for EEG were much different. You could code if a study was done portable, not today. You were able to code differently if a study was done with hyperventilation (HV) and one done without HV. It is important for END techs to be familiar with coding changes so studies are performed as ordered but also so they can be coded correctly. The bottom line is making sure your reimbursement will be the maximum for each study performed. This may be to some techs a “have to learn” thing, but remember reimbursement can help in keeping your position. END labs should be informed by their billing office when codes have changed. It is equally important for the END lab to inform their billing office if a study was not performed exactly as ordered or coded. An example would be if a study was run less than 20 minutes. It could be coded with a modifier to maybe get total or partial reimbursement. Patient care should always be a first priority but learning as much as possible will only make that care better. Just remember not to blind them with all your diamonds!! END EDUCATION By Mary Feltman, R. EEG T., BS My first clinical rotation was to Methodist Hospital in Madison, Wisconsin where I met Dick Kopenski. This man taught me four important things that I share with my students. 1. When in doubt, Read the railroad tracks. Of course, this was using analog equipment; when looking for subtle findings just tilt the page and read the tracks or lines. Railroad tracks are parallel lines that show any twist or curve. In EEG, the channels also run parallel and will show anything out of the ordinary; good trick for subtle slowing. 2. Before starting that electrocerebral inactivity (ECI) tracing, always run a few pages on maximum sensitivity. Fix anything that might give you grief and then toss this. Start the official study. By simply running a few pages to check the tracing, you will be able to submit a clean near perfect tracing to be read. Now you can stand a little taller, straighter and prouder! 3. Don’t worry about not knowing all the medications. Simply ask every patient, “Why do you take that medication?” The patient should tell you why they take it and this gives you more information for the history. You have just killed two birds with one stone and still look like you know all the answers. 4. Lastly …..Always remember….. a pineapple malt takes care of anything. No matter how difficult the patient or study was there is always something that will take the anguish away. For Dick, it was a trip downstairs to the Ice Cream Shop; a pineapple malt was his security blanket. For you it might be chocolate or a margarita. Remember, nothing is ever that bad. Thanks Dick for teaching me, and now my students, things that have been and will always be helpful to an END Tech. By Mark Ryland, R. EP T., RPSGT, R. NCS T., MA Take responsibility for your actions and always check the patient’s wrist band and orders! I share this story with every group in my Introduction to Electroneurodiagnostics Course, END 1300. It was a Monday morning, we had nine EEG orders waiting for us (myself and the other END Tech), and three were portable. We also had three outpatient NCSs and two outpatient EEGs. Being the young, energetic, and occasionally overly enthusiastic person I am, I immediately grabbed one of our analog EEG instruments and headed to the ICU to begin the portables. The first procedure was on a 78 y/o female who was semi-conscious and on a ventilator. After completing the test I began to roll the EEG instrument out of the room to move on to the next patient, Dr. Smith (patient’s attending MD) was standing in the doorway. Dr. Smith was known for his temper and his ability to remove the spleen of anyone who crossed his path for pretty much any reason he saw fit. He asked me, “What the @#%% are you doing?” To which I replied, “The EEG you ordered.” His response, “I didn’t order an EEG on this patient!” To my horror, I looked at the order in my hand, and the patient’s chart in his hand, and realized the order was for the patient in the next room. At this point, looking over Dr. Smith’s shoulder, I noticed the ICU nurses were diving under their desks, because they did not wish to become collateral damage from the carnage that was about to ensue. I had two choices. I could give Dr. Smith a lame excuse, in which case he would remove my spleen, probably through my nose, or I could do what I did. I looked him squarely in the eyes and calmly stated, “Dr. Smith, I just did an EEG on the wrong patient. There no excuse for it, I am terribly sorry, and it will never happen again.” His response was calm and cool, “OK. Now get the @#%% out of here and do the EEG I did order!!” Moral of the story: You will make mistakes: own up to them. And be sure to check the patient’s wrist band and orders! Continued on page 23 왘 MARCH 2009 • Volume 33, Number 1 ASETnews 22 I NTEREST S ECTION B RIEFINGS continued Interest Section Briefings. . Continued from Page 22 EPILEPSY MONITORING By Cheryl Plummer, R. EEG T., BS The Importance of a Meticulous 10/20 Set Up For Long-Term Video Monitoring The EEG setup is crucial in any EEG that is performed. It is critical that the patient is measured correctly, the impedances are within an acceptable range, and the electrodes are applied securely and in the correct place. It is of the utmost importance that electrodes are placed in the same manner when performing long-term monitoring. Not only should the electrodes be applied correctly, but they should be protected and maintained meticulously. It is important that the basic skills that we developed when we were a beginning technician remain impeccable as the years progress. Remember, there are no short cuts when it comes to measuring – it should be done the same way each time. Experience does not allow the use of short cuts; remember that short cuts make long work!! In our EMU, we apply our electrodes with collodion and gauze squares. We always place the electrodes on the head with the stem of the electrode pointing to the back of the patient’s head. This allows gravity to work with us rather than against us. After all of the electrodes are applied securely, filled with electrode cream and impedances checked, and the recording started (it is always a good idea to start recording before wrapping in case there is an electrode not working properly), we wrap the patient’s head with gauze wrap (does not have to be sterile for noninvasive monitoring). When wrapping the head, we go a few turns around the head and then we pull all the wires together in the back and wrap the gauze around them a few times making a “pony tail” and then wrap the gauze around the head a few times again. This keeps the wires all together in one location so that they are not getting caught on the bed, etc. We also tie the wires together in two other places to keep them secure. Electrodes should be checked every morning and refilled. If there are problems with electrodes throughout the day, they should be fixed immediately. The EEG is worth nothing if it cannot be read due to artifact. Sometimes we overlook the simplest details that make our job easier. INTRAOPERATIVE NEUROMONITORING By Eric Isaacson, R. EEG/EP T., CNIM Surgeries involving the brain, brainstem, and cranial nerves offer special challenges in regards to neuromonitoring. More than any other type of neurosurgery, intraoperative monitoring during craniotomies requires that a monitoring technologist use certain basic skills and concepts to provide clear, interpretable data for these procedures. These skills include having the ability to successfully identify and correct electrical and physiological artifacts. Eliminating artifacts during craniotomy surgeries begins when the monitoring tech first enters the operating room (OR) suite. Initial setup tips such as positioning your equipment as far away from other electrical devices as possible, and using a power receptacle that will not be used for any other electrical devices is key. A good rule of thumb is to keep your electrode input boxes as far away from light sources, hot lines, and bear-huggers (patient warmers) as possible. You must anticipate the OR bed being rotated, so be mindful of how you are running any cables to the bed. Also anticipate that the head of the bed may be disassembled in preparation of Mayfield headrest/tongs being used. Remember, during craniotomies, the head of the OR bed is where the surgeon will MARCH 2009 • Volume 33, Number 1 be standing. It is also where the microscope will be positioned, and all puddling from fluid loss will occur. To avoid all of these potential issues, and cut down on congestion, it is a wise idea to wait until the patient and bed are in final position, and all electrodes are in place before placing your electrode boxes on the OR bed. The second and most important concept in reducing artifact involves the actual placement of electrodes. Placing and securing electrode for craniotomy surgeries are especially important because once the procedure has been started; there is no crawling around under the drape to re-apply electrodes. Since the OR is usually so congested with staff for intubation and positioning of a patient for a craniotomy, I typically do as little placement of electrodes as possible prior to head pinning. In a typical craniotomy where the surgeon wants upper and lower SEPs and monitoring of cranial nerves VII and VIII, I will only place the stimulating electrodes for the ulnar and posterior tibial nerves, popliteal fossa electrodes, and the tubal insert for the downside ear. Only after the head is secured in pins, and feducials have been registered will I place all other electrodes. This ensures that my electrode placement is neat, and everything is completely secure. If tongue and soft palate electrodes need to be placed, this also needs to be done prior to positioning of patient. It is a good idea to test ABR transducers or VEP goggles prior to placing them on the patient to ensure that they are not faulty, and stimulation is actually being delivered. Troubleshooting artifacts during craniotomies can be a very frustrating and complicating task. However, most of the artifact battle can be won prior to actually acquiring data. Being able to provide clear, interpretable data during these procedures is the trademark of an attentive, thorough technologist who carefully prepares and implements a "game plan" prior to his/her case. NERVE CONDUCTION STUDIES By Jerry Morris, R. NCS T., MS Years ago I read a comic strip (BC), I believe, where at the end of the last panel, the principal character, a hungry anteater, sees a whole line of ants marching away. He proudly turns to his friend and calls them by their Latin name. In the meantime, the ants scurry into their anthills, out of harm’s way. The anteater then sighs and says “You get TOO much education, you starve to death”. I disagree with the first part of that statement; I don’t know about the “starving-to-death part. I firmly believe the more you learn, the better off you will be. To me there is no such thing as TOO much education. It is a principle that my parents instilled in me at an early age and was reinforced during graduate school and my early life in the real workplace. It is how I go about every day of work, looking for opportunities to learn something new and then share it with others. I came into the electrodiagnostic field backward from most people I know. Most of them learned EEG first and then progressed into EPs, IONM, and then EMG/NCV. I was first an EMG tech who took the road less traveled, finally learning EEG after my 50th birthday! What a fascinating and wonderful adventure it has been. Soon after learning EMG, I even deviated into nerve and muscle histology for a few years. The physician I worked with was an EMG specialist with a subspecialty in muscle and nerve biopsy and histology. For several years I would see the evidence of denervation, demyelination, axonal loss, etc., electrically in the EMG lab one day and then see the same evidence histologically the next few days from the same patient(s). I didn’t fully appreciate the Continued on page 24 왘 ASETnews 23 I NTEREST S ECTION B RIEFINGS continued Nerve Conduction Studies. . Continued from Page 23 wellspring of knowledge and application of principles until after the histology work was performed by the pathology technologists. Later I progressed to EPs, learning new skills that would help me as I began IONM work. Not only could I do these studies clinically, but I could also put them to use in aiding the surgeons during surgical procedures. The EMG portion was a great plus. My physician encouraged me to watch and learn EMG specifics from them, recognizing waveforms and insertional activity and asking any questions I might have, though not interpreting the studies. This gave me a much better understanding when I actually went into the OR. Again more knowledge and education proved beneficial to the nth degree. I really can’t wait to see what happens the next few years in our field. New techniques and procedures and info are there to learn and pass on. The internet provides a gold mine of knowledge waiting to be mined. “Learn and share, learn and share.” Make that your mantra so that future generations of electrodiagnostic technologists will be able to benefit from their predecessors. As we celebrate ASET’s 50th anniversary, let’s make the next 50 years a half century to remember... NEW TECHNOLOGIES & RESEARCH By Leah Hanson, R. EEG/EP T., AAS At the recent WSET meeting, held in Seattle, a presentation was given outlining the “new” commercial technologies that are using biofeedback and other similar methods. Various “gaming” systems are using biofeedback style methods to develop headsets that can control gaming pieces with thought techniques and muscle/movement potentials. These wireless gaming headsets are poised to integrate with current systems such as Xbox and PlayStation. This in itself is quite interesting but as it relates back to our field is even more interesting. These headsets are also being developed for wheelchair control for paraplegics and other quality of life limiting situations. The headsets can control the movement of the wheelchairs by relaxation techniques, blinking, eyebrow movements, smiling, etc. Obviously, these headsets, which use “non-prep” electrodes and highly filtered algorithms to accomplish the activities described, will continue to be developed to record more discreet activity, which could potentially lead back to the diagnostic field of neurodiagnostics and other affiliated fields. EEG of the future…..interesting. PEDIATRICS AND NEONATOLOGY By Shelley Gregory, R. EEG T. The topic of the month is for us to “get back to the basics” and how I have applied that somewhere in my career. We are fortunate to be involved in an EEG program through one of the local community colleges (Bellevue Community College). Having students is always refreshing but they certainly have a lot of questions. They always want to know what it was like in the old days and I always share my story of when I first started working here years ago and how one situation made me vow to never put anyone else in that predicament. Orienting to a new job, whether in a pediatric or an adult hospital, is overwhelming but quite similar. One of the main hurdles is to have a working understanding of all the policies and procedures unique to the EEG lab you are orienting in. It is the responsibility of the supervisor to make sure an orientation covers all the nuts and bolts of a department. Well, not so for me when I started here many years ago. The supervisor of the EEG lab was getting ready to retire and really didn’t want to be bothered by training someone new. I now realize how important communication, whether verbal and/or written, is when you are orienting someone. In those days there were no manuals with policies and procedures. It was left up to the current technologist to just tell you what you needed to know and hope for the best. On the third day that I was working an order for a portable EEG in the ICU came in so I immediately went to perform it. I was really feeling good about myself and thinking it would be so simple - not so fast. Well, believe it or not at that time montages were either manually punched into a Grass machine or the Beckman machine was pre-dialed in with montages using 1, 2, 3 etc… (each number depicting a bipolar or referential montage). Seattle Children’s Hospital had a Beckman machine which meant they were pre-dialed in. As I was running the EEG, the neurology team came by to take a peek at the recording. The attending neurologist looked and asked what montage I was running. Without even thinking I blurted out “1” and then realized I didn’t know what the actual montage was. Was it a bipolar or referential montage? I cursed myself internally for not knowing this but I also vowed that if I could I would never put another new technologist or student through the humiliation I felt. Now whenever a new EEG technologist comes on board and a new student starts their clinical rotation, they are given a copy of policies and procedures so they have everything they would need to perform one of our many types of EEG studies. By “getting back to the basics” we need to prepare people for everything that one study encompasses. The tech or student then has something to look at and figure it out before he/she is humiliated by the new peers. I have been the supervisor of the EEG lab for about 15 years now and am always commended for putting together such a complete manual every time someone new comes aboard. If they only knew!! POLYSOMNOGRAPHY By Kathy Johnson, R. EEG/EP T., RPSGT Back to basics in polysomnography for me is really back to basics in EEG. While sleep studies incorporate a wide range of physiological signals and require significant expertise in a variety of fields, the recording of these signals comes from the world of EEG. Now the interpretation of what you are recording is another matter, best left to another article………… When we look at the way we record sleep studies, we realize that a solid understanding of EEG instrumentation is necessary to really comprehend how these tiny electrical signals get from the patient to the screen in front of us. There may be some who believe that one does not need to understand the frequency response curve to run a good sleep study, and that may be true to a certain extent. Today’s equipment often includes headboxes with body illustrations showing the tech where the electrode should be placed on their patient. Instruction books frequently contain a “cookbook” of instructions to allow a technician with little or no knowledge to run a decent sleep study on many patients under ideal circumstances. But is that what we really want? Having the basic knowledge of filters is invaluable in understanding why it is appropriate to use a high frequency filter of 15 hertz on an airflow channel but not on an EMG channel. Understanding that 60 Continued on page 25 왘 MARCH 2009 • Volume 33, Number 1 ASETnews 24 I NTEREST S ECTION B RIEFINGS continued Polysomnogrophy. . Continued from Page 23 hertz artifact is not a “fuzzy black worm” (as I have heard it called) on the screen but a high frequency artifact that can be eliminated in most cases is pretty darn important. Using the correct terminology such “75 microvolt delta activity” instead of “big, slow stuff ” takes polysomnography out of the realm of button pushing, into the realm of a profession. Knowing why impedances should be under 5K ohms and equal can result in cleaner, more informative tests for our patients. All this being said, we all realize that polysomnography includes technology which is foreign to EEG techs, such as continuous positive airway pressure machines, pressure flow transducers and inductive plethysmography, etc. However, even these devices are interfaced with equipment that is basically an EEG machine in disguise. Is that disguised EEG machine a wolf in sheep’s clothing? For the tech without a basic understanding of EEG, it can be………….. TECHNOLOGISTS WORKING ALONE By Sunday Dale, R. EEG/EP T., CNIM, BAS You have probably heard the expression that you have to “walk the walk and talk the talk” to get ahead in today’s world. This is true not only today but has been for a long time. I remember when I first started in EEG and could not say or remember the word “electroencephalogram,” but knew that EEG was an abbreviation for it and much easier to remember. I learned that the EEG test or that word that was so hard to say and remember meant “a recording of brain wave activity.” As I was learning about electrodes, their locations on the scalp and the break down of the head into lobes it occurred to me, there was much more to this EEG stuff than just learning the three finger placement method for the electrodes. I learned of an adult evening education course called “Medical Terminology.” This course was being offered at one of the local high schools, and so I signed up for it. After taking the medical terminology course and buying Dorland’s Medical Dictionary, I finally started to understand what “talk the talk” meant! Terminology is an area that techs who are taking their boards often leave behind or forget because they do not talk the talk on a regular basis. One of the things I did in the beginning was to make a list of words that I did not know or understand when reading an article or book and look them up in the dictionary, re-read the statements using the meaning instead of the word. I found this helped a great deal with understanding what I was reading. I also developed the habit of talking the terminology for example when I learned the International 10/20 System I would say, “Fp1 is Frontal Pole Left and Fp2 is Frontal Pole Right.” Then I was comfortable, regardless of whom I was talking to using either of the terminologies. Terminologies are interchangeable regardless of the modality of electroneurodiagnostics (END) you are talking about. When techs “talk the talk” they can definitely “walk the walk” with their head held high! 쎲 CREDENTIALING ORGANIZATIONS The following organizations administer and award the R. EEG. T., R. EP T., CNIM, CLTM, RPSGT and R. NCS T. credentials to technologists. For specific requirements, including re-certification, refer to the individual Websites for the most current updates. American Board of Registration of EEG & EP Technologists CREDENTIALS: R. EEG T.®, R. EP T.®, CNIM®, CLTM®, and EEG Laboratory Accreditation FOR MORE INFORMATION For general information and to obtain oral exam applications, contact: Janice Walbert, R. EEG/EP T., Executive Director ABRET Executive Office 2509 W. Iles, Suite 102, Springfield, IL 62704 217.726.7980 ; 217.726.7989 fax [email protected]; www.abret.org Written exam applications can be requested by contacting: Professional Testing Corporation 1350 Broadway, 17th Floor New York, NY 10018 212.356.0660 phone www.ptcny.com MARCH 2009 • Volume 33, Number 1 American Association of Electrodiagnostic Techs [AAET] CREDENTIAL: R. NCS T. Board of Registered Polysomnographic Technologists [BRPT] FOR MORE INFORMATION CREDENTIAL: RPSGT™ P.O. Box 6823 Mobile, Alabama 36606 Ph: 877.333.2238 or 877.333.AAET [email protected]; www.aaet.info [Accredited by the National Commission of Certifying Agencies – NCCA] Written exam applications can be requested by contacting: Professional Testing Corporation 1350 Broadway, 17th Floor • New York, NY 10018 212.356.0660; www.ptcny.com FOR MORE INFORMATION John Ganoe, CAE, Executive Director Board of Registered Polysomnographic Technologists 8400 Westpark Drive, Second Floor McLean, VA 22102 703.610.9020 • 703.610.0229 (fax) [email protected]; www.brpt.org ASETnews 25 READY REFERENCES The following listings are numbers and addresses frequently requested from the ASET Executive Office. They are published as a service to members. Illinois Society of END Technologists Phyllis Skowron Videtich, R. EEG T., President, 2907 Heritage Drive, Apt. 3, Joliet, IL 60435; 815.725.7133 ext. 3824; [email protected] International & Foreign END Societies Indiana Society of END Technicians & Technologists Sarah Jean Vivo, R. EEG/EP T., CLTM, President 317.338.3004 Fax 317.338.6816 www.isetthome.org Canadian Association of Electroneurophysiology Technologists Kimberly Skanes, RET, RT [EMG], The Moncton Hospital Electrodiagnostic Services, 135 MacBeath Ave., Moncton, NB E1C 6ZB; 506.857.5272; 506.857.5697 fax; [email protected]; www.caet.org International Organisation of Societies for Electrophysiological Technology [OSET] Karen Woolcock, Staffordshire General Hospital, Stafford, ST163SA, United Kingdom: +44(0)1785 230237 fax; [email protected] Regional, State & Local END Societies Alabama Society of END Technologists Allen Lee, R. EEG T., President; www.alaset.org Central Society of END Techs [CSET] Ed Carlson, R. EEG/EP T., CNIM, CLTM President, 651.241.5192; [email protected] Charles E. Henry Society of END Techs Steve Erickson, R. EEG T., President, Epilepsy Monitoring Unit, Strong Memorial Hospital, Rochester, NY 14642; [email protected]; www.cehenrysociety.org Greater New Orleans END Society Lynn Causey, R. EEG T., President, Children’s Hospital, 200 Clay Ave., New Orleans, LA 70118; 504.896.9596; [email protected] MARCH 2009 • Volume 33, Number 1 Iowa Association of END Technologists Dawn Byrne, R. EEG T., President, Trinity Regional Medical Center, 802 S. Kenyon Rd., Ft. Dodge, IA 50501; 515.574.6189 phone; [email protected] Michigan Society of END Techs Connie Kubiak, R. EEG/EP T., CNIM, CLTM President, Munson Hospital, 9239 Vans Lane, Kingsley, MI 49649; 231.590.7118; [email protected] Minnesota ENT Technologists Society [METS] James Kvasnicka, R. NCS T., CNIM, President, 640 Jackson St, St, Paul, MN 55101; 651.254.3740; [email protected] New England Society of END Technologists Jack Connolly, R. EEG T., President; 617.355.7847 [email protected] North Carolina Society of END Technologists Doaty Flanigan, 170 N. Davidson Dr., Winston-Salem, NC 27107; 336.718.5569; [email protected] Puget Sound END Society Carol Riley, R. EEG/EP T., RPSGT, CNIM, President, Puget Sound Health Care System; 206.277.3301; [email protected] Southern Society of END Technologists Kyle Kalkowski, R. EEG T., President, 8102 Lair Court, Chapel Hill, NC 27516; 919.966.1686; [email protected]; www.sset.org Western Society of Electrodiagnostic Technologists Kristin Roberts, R. EEG/EP T., President; 714.771.8000 ext. 7187; [email protected]; www.wset.org Wisconsin Society of END Techs Colleen Helling, R. EEG T., RPSGT, President, 1413 Terrace Court, Two Rivers, WI 54241; 920.288.4350 or 920.553.7075; [email protected] Other Resources Committee on Accreditation for Education in Electroneurodiagnostic Technology [CoA-END] Theresa Sisneros 6654 S. Sycamore St., Littleton, CO 80120 303.738.0770; 303.738.3223 fax [email protected] Epilepsy Foundation 8301 Professional Place, Landover, MD 20785-7223; 800.332.1000; www.epilepsyfoundation.org Northeastern Society of END Techs Kathy Curzi, R. EEG/EP T., President, 2028 Country Pl, Bethlehem, PA 18018; 610.867.7183; [email protected] Ohio Society of END Technologists Sheryl Nehamkin, R. EEG/EP T., CNIM, CLTM, President, 4075 Eastway Road, S. Euclid, OH 44121; 216.844.2377; [email protected] ASETnews 26 WORKSHOPS, COURSES AND SEMINARS Electroneurodiagnostic Education Knowledge Plus, Inc EEG, EP, IOM, Polysomnography Courses P remier END education company with quality driven and board focused courses and on-site training for practitioners seeking INTERACTIVE training experiences. Class size is kept small to provide individualized attention to all levels of technologists. Classes held near Chicago with access to all of the excitement of the city! Custom Training at YOUR FACILITY. Call for Quotes Today Intraoperative Monitoring: Comprehensive Basic & Advanced APRIL 2-4 SEPTEMBER 5-12 Evoked Potential Written Board Prep Course JUNE 13-14 AUGUST 1-2 CNIM® Board Preparation JUNE 13-14 AUGUST 1-2 Evoked Potential Oral Board Prep Course MARCH 28-29 JULY 25-26 Evoked Potentials Course Comprehensive EPs for the IOM Professional & Clinician MAY 27-29 Electroencephalography Comprehensive Basic to Advanced Course: MARCH 16-20 AUGUST 17-24 NOVEMBER 9-13 EEG Written Board Prep Course MARCH 21-22 AUGUST 25-26 NOVEMBER 14-15 EEG Oral Board Prep Course MARCH 27-28 JULY 24-25 Larry Head Institute Long Term Monitoring Prep Course MARCH 7-8 AUGUST 15-16 OCTOBER 3-4 Polysomnography Board Preparation Course MAY 16-17 AUGUST 8-9 OCT 24-25 Virtual Classroom: Comprehensive Intraoperative Monitoring TBA For detailed training package, custom quotes, and additional information contact: Rebecca Clark-Bash, R. EEG/EP T., CNIM, F. ASNM, Knowledge Plus, Inc., PO Box 356, Lincolnshire, IL 60069 Phone: 815.341.0791. Visit us on the web at eknowledgePlus.net. 2009 ASET Educational Seminars May 1 – 2, 2009 Cleveland, OH [Host – Cleveland Clinic] • EEG Technology: A Comprehensive Review Course • Mastering Nerve Conduction Studies • Autonomic Testing [May 2nd Only] Scholarship Deadline: February 2, 2009 October 2 – 3, 2009 Pasadena, CA [Host – Huntington Hospital] • Advanced LTM/ICU Monitoring • Comprehensive Polysomnography Course Visit the ASET website, www.aset.org and click on the Meetings tab for course schedules, hotel accommodations, faculty, registration rates, and to register online. E lectroneurodiagnostic technology training courses in EEG, EEG Board Preparation, Evoked Potentials and Intraoperative Monitoring are offered to meet the needs of practicing technologists seeking additional training or as preparation for registry exams. Classroom-style format encourages instructor-student interaction, creating a relaxed learning atmosphere for all technologists, regardless of the level of knowledge and experience. For course descriptions, dates, costs and to even register on-line visit our WEB SITE: www.larryheadinstitute.com or call/ write to Larry Head Institute, LLC., 242 Bates Lane, Monroe, MI 48162; 734.240.3383; 734.240.3393 fax; or e-mail [email protected]. 쐌 EEG Fundamentals March 16 – 20 July 20 – 24 November 2 – 6 쐌 EEG Board Preparation April 2 – 4 August 20 – 22 쐌 Evoked Potentials May 11 – 15 October 12 – 16 쐌 Nerve Conduction Studies February 6 – 7 June 19 – 20 October 9 – 10 쐌 Polysomnography Fundamentals March 20 – 29 October 9 – 18 쐌 Polysomnography Scoring June 13 – 14 November 7 – 8 쐌 Polysomnography Board Preparation February 7 – 8 April 25 – 26 August 8 – 9 October 24 - 25 쐌 Intraoperative Monitoring March 26 - 28 July 30 – August 1 November 19 - 21 쐌 CNIM® / IOM Board Preparation January 16 - 17 June 26 - 27 Scholarship Deadline: July 3, 2009 MARCH 2009 • Volume 33, Number 1 ASETnews 27 CALENDAR OF EVENTS ASET calendar of events 2009 APRIL AUGUST NOVEMBER April 1 WEBINAR: Brachial Plexus Anatomy and NCS Testing with Case Studies Aug 5 – 8 ASET 50th Annual Conference Nov 4 WEBINAR: Classification of Pediatric Seizure Disorders April 8 WEBINAR: MEG: Magnetoencephalography April 22 WEBINAR: Event Monitoring in the ICU MAY May is “Stroke Month” May 1 & 2 Educational Seminars – EEG Technology: A Comprehensive Review Course; Mastering Nerve Conduction Studies May 2 Educational Seminar – Autonomic Testing May 6 WEBINAR: Special Extended Full Day WEBINAR: Evoked Potentials May 13 WEBINAR: Monitoring the Recurrent Laryngeal Nerve May 20 WEBINAR: IONM Using Motor Evoked Potentials ASETnews ISSN 0886-5620 ASET 6501 East Commerce Avenue, Suite 120 Kansas City, MO 64120 SEPTEMBER Sept 9 WEBINAR: Ancillary Equipment in the LTM Unit Sept 16 WEBINAR: Pediatric EEG Case Presentations Nov 11 WEBINAR: Upper Ext Entrapment Neuropathies Nov 18 WEBINAR: Medication Affects on EEG and Update on Current AEDs Sept 23 WEBINAR: Record Review in EEG OCTOBER Oct 2 & 3 Educational Seminars – Advanced LTM/ICU Monitoring; Comprehensive Polysomnography Course Oct 7 WEBINAR: Subclinical Seizure Case Presentations Oct 14 WEBINAR: Current Trends in Pedicle Screw Stimulation Oct 22 & 23 WEBINAR: Special Two Day Webinar: Growing Your END Business Oct 28 WEBINAR: Understanding TCD Announcement Policy - The appearance of meeting, course and workshop announcements in this newsletter does not constitute endorsement or approval by ASET of the content or quality of the program. Announcements are accepted subject to publishers approval, must be relevant and may be altered for clarity, style and length. Most events are paid advertising.