Training activity: 5

Details

Obtain, report, document and feedback baselines for the modalities being monitored in spinal surgery. To include:

 

• Lower limb somatosensory evoked potentials
• Upper limb somatosensory evoked potentials
• Lower limb motor evoked potentials
• Upper limb motor evoked potentials
• Upper limb free-run electromyography
• Lower limb free-run electromyography

Type

Entrustable training activity (ETA)

Evidence requirements

Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion. ​

Reflection at multiple timepoints on the trainee learning journey for this activity.

Considerations

• Set up verification
• Establishment of stimulus parameters for somatosensory and motor evoked potentials
• Neuromuscular agents
• Train of four
• Anaesthetic agents and protocols
• Effects of anaesthesia on the central nervous system
• Waveform characteristics
• The impact of physiological variables
• Other anaesthetic considerations
• Baseline correlation with clinical presentation
• Sensitivity and specificity
• Diagnostic uncertainty

Relevant learning outcomes

#	Outcome
# 1	Outcome Follow the pre-operative plan for intraoperative neuromonitoring for spinal surgery, making any necessary adjustments based on information available on the day of monitoring.
# 2	Outcome Set pre-operative baseline recordings for intraoperative neuromonitoring for spinal surgery.
# 3	Outcome Record free running and/or triggered electromyography during intraoperative neuromonitoring for spinal surgery.
# 7	Outcome Demonstrate effective and professional communication skills with the multidisciplinary theatre team.