Users Manual Part 1
32
Nerve Integrity Monitor
Important note on stimulator adjustments
By selecting a procedure, the default settings for stimulus intensity normally provide adequate stimulation. The absolute stimulus
intensity required to adequately stimulate any motor nerve is determined by a complex combination of several factors including
(but not limited to) the following:
• The functional health of the nerve itself.
• The type of stimulation probe used (monopolar or bipolar).
• Proximity to the nerve.
• The pulse width of the stimulus.
You should use the amount of stimulation necessary to elicit a detectable EMG event. Stimulus current levels of 0.3mA may be high
enough for adequate direct monopolar stimulation of the facial nerves, but may elicit little or no response when monitoring nerves
during thyroid procedures. The best guideline for setting the stimulus intensity level is to use the lowest amount that produces an
EMG event. Under- and over-stimulation are covered under W19, W20, and W26 in the “Warnings” topic.
The surgeon should be aware:
• That STIMULUS is continuously being applied to the STIMULATOR probe and/or the Nervassure stimulator.
• STIMULATING the patient is the result of physical contact between the patient and the STIMULATOR probe.
• The STIMULATOR probe should be kept ISOLATED when NOT STIMULATING the patient (except Nervassure).
Note: Stimulator adjustment involves the adjustment of the Current, Rate, Pulse Width, and the Stimulus/Rejection Period.
Note: To prevent inadvertent high stimulus levels, the rst time the stimulus level exceeds the Current Warning Level (9), a dialog
box opens:
• Stimulus in excess of the current warning level (usually 3 mA).
• Press [CONFIRM] to enable stimulus.
If using the procedures Lower Extremity, Knee, or Ankle, the stimulus level warning is set at 12.0 mA.
Titles and comments
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1 Enable quick tags toggle.
2 Edit custom titles and comments list.
3 Move forward/backward through title/comment list.
4 Selected item is a quick tag title toggle.
5 Create a new title/comment/quick tag.
6 Edit a title/comment/quick tag.
7 Delete a title/comment/quick tag.
The edit custom titles and comments feature enables you to create new titles/comments or delete entries that have already been
created including the default titles. The Edit and Delete buttons appear when you select an existing item in the list. The titles/
comments specic to the procedure type that the user is monitoring.
1. Press .
The Settings panel appears.
2. Press the Titles and Comments button.
A list of titles for the current procedure appears.
3. Do any of the following:
FCC use only, not for Medical use