Users Manual Part 1

53
Nerve Integrity Monitor
5
Electrode reading is (lead o):
(+ or -) O
Electrode laying on skin surface.
Surface electrodes may have too high of impedance
to be used which causes the symptom.
Electrode placement insecure.
Re-insert electrode in question.
Dirty electrode tip.
Electrode cable is broken.
Remove and replace electrode in question.
Electrode pin disconnected from patient interface. Check connection to Patient Interface box.
6
Electrode imbalance is too high.
> 2KΩ (Subdermal electrodes)
> 10KΩ (Prass Paired electrodes).
Dirty electrode.
Remove and replace electrode for appropriate channel with
highest impedance reading rst.
Mismatched pair.
Unequal placement.
Remove and replace electrode in question.
7
Stimulus Return Impedance is shown high
on the Electrode Check panel (Question
mark at STIM 1, STIM 2, or ground).
No stimulus return electrode connected.
Ground not connected.
Excessive electrical noise on the patient interferes
with NIM electrode measurement.
Connect the stimulus return electrode.
Connect ground.
Identify and eliminate the source of the noise. Proceed to
monitoring and verify stimulus delivery via stimulus current
return value.
8
Unexpected artifact events on the NIM.
Metal-to-metal discharge artifact.
Determine response type from waveform pattern on 50ms
screen.
Intertwined recording electrode and stimulator wires. Disentangle recording electrode and stimulator cables.
Inadvertent manipulation of electrode wires, Patient
Interface cable, or recording area on patient.
Check area near recording electrodes for excessive
stretching from tape, drapes, etc.
Electrical interference from other equipment.
Check for intermittent stimulation from anesthesiologist
(i.e., hand-held electrical stimulator).
Move NIM Vital system away from source of interference.
Make sure Patient Interface cable and electrode wires do not
cross other electrical equipment or cables.
9
Interference on external anesthesia
equipment (ECG Monitor) from the NIM.
Electrode Check automatically generates current
through the electrodes during setup.
Try an alternate ECG Lead set.
Electrode Check automatically generates current
through the electrodes during monitoring when
selected by the user.
Deselect Electrode Screen.
Muting function active. See Excessive Muting (Symptom Column).
With Stimulator active. Turn the NIM Stimulator to 0.0mA when not needed.
10
Electrosurgical unit causes interference
with the NIM screen and audio.
The muting lter may not be enabled. Turn muting lter on.
The muting lter is insucient. Consider using external muting detector.
Electrosurgical grounding inadequate. Check electrosurgical grounding pad on patient.
NIM Vital system or Patient Interface cable too close to
electrosurgical unit or its cables.
Maintain separation between electrosurgical cable and the
NIM system.
11
Excessive Muting causing monitoring to be
disabled (the muting message appears on
the screen.
Unit receiving excessive signal.
Disconnect the muting detector completely.
Turn o the muting software lter.
12
Inadequate muting causing monitoring
artifact events and audio noise.
The muting lter in the software may be inadequate
or turned o.
If using the optional muting detector, it may be
damaged, or not plugged in to the NIM.
The Muting Detector is not plugged into the NIM.
The electrosurgical unit’s signal is too low to be
muted.
May not be using the correct Muting Detector.
Ensure the muting lter is turned on in the software.
Inspect the internal jaws for damage.
Plug the Muting Detector into the NIM.
Loop the electrosurgical unit cable and clip the muting
detector over the doubled cable.
13
Rhythmic Artifact from pacemaker in safe
mode.
Pacemakers – Pace Pulse is picked up by the NIM
electrodes or EMG tube.
Relocate electrode ground and stimulus return to patient’s
shoulder (Acromion).
14
Incrementing Probe will not adjust
stimulation.
Loose connector, or not plugged into the patient
interface.
Check connector is properly aligned and fully seated (See
System Set-Up / Patient Interface Set-Up).
15
Incrementing Probe stimulus keeps
changing (run away).
Bad Incrementing Probe.
Replace Incrementing Probe or disconnect STIM CONTROL
connector and manually adjust stimulus at touch screen.
FCC use only, not for Medical use