Users Manual Part 1

Nerve Integrity Monitor

Note:

• You can bypass the next place electrodes screen by selecting the MONITORING tab or .

• If you bypass the Check Electrode screen, no pre-surgery impedance values of the electrodes, ground, or STIMreturns are

available for printed/saved reports.

• If the patient interface, electrodes, ground, or STIMreturns were disconnected when you exit the Check Electrode screen, any

printed reports will show a failure of the impedance values of the disconnected item(s).

• There is no STIM status (blank) if you select Bipolar on the Probe Type (located in the Settings/Stimulation Panel).

• STIM2 appears after you turn it on using the Activate button located on the main screen, or by selecting the STIM2 from the

drop-down list on the Stimulation Panel.

Edit channel names

From the Electrode Check page, the user can open the Edit Channels panel. This panel enables adding, editing, and removing

channels from the selected procedure. Once changes have been made, select [Apply Changes] to use the settings in the current

procedure only, or select [Save to Prole] to save the channels for current and future use. The user can also reset changes to the

latest save point (or to default in a default procedure) by selecting [Reset to Saved].

MONITORING tab

Access the MONITORING screen by pressing MONITORING on the top tool bar, or .

The main monitoring screen helps provide EMG information to the surgeons. The EMG information can be free running and

stimulation evoked.

EMG Display

Free-running EMG

If the user has Event Capture disabled on the Threshold panel, the NIM Vital system continuously displays free running EMG picked

up by the electrodes. If the user enables Event Capture, the system only displays values above the threshold values.

Evoked EMG

The surgeon can use the stimulator probe to conrm the location and integrity of the nerves. When the surgeon touches the surgical

site with the STIM probes, one of the two following events happen:

You can expect one of two events:

• Stimulation with an EMG response - This event occurs when the stimulation device touches healthy nerve tissue that is capable

of propagating an action potential that reaches its innervated muscle tissue. The surgeon will notice the following on the

console:

— Audio (thump, thump, thump, thump)

— Biphasic wave form

— An amplitude value

— A STIM measured value

• Stimulation of tissue, but no EMG response - This event occurs when the stimulation device touches non-nerve tissue, or if the

current delivered is not sucient to propagate an action potential. The surgeon will notice the following on the console:

— Hear the current delivery tone

— See a STIM measured value

A detailed list and explanations of all the monitoring screen buttons are displayed below.

FCC use only, not for Medical use