Training activity information
Details
Monitor and interpret recorded responses throughout surgical procedures for spinal, to include:
- communicating with the theatre team,
- identifying and responding to factors impacting responses
- documenting any relevant pathogenic, non-pathogenic, and neurophysiological changes when required.
For at least one the following:
- Triggered electromyography
- Free-running electromyography
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Considerations
- Physiological variations and tolerances
- Anaesthetic fade
- Warning criteria (alerts) for free running and / or triggered electromyography
- Artefacts
- Timely and effective communication
- Technical issues
- Effects of anaesthesia on the central and peripheral nervous system
- Effects of anaesthetic and neuromuscular agents on free running and / or triggered electromyography
- Systemic variables
- Stop moments
- Surgical techniques and procedures e.g. osteotomies, distraction, decortification.
- Electromyography, firing
- Anatomy of spinal column and innervated muscles
- Probe/ stimulator types
- Surgical context i. pedicle screw, XLIF, TLIF
- Documentation
- Monitoring, anaesthetic, and surgical actions to be taken in the event of a warning (alert)
- Reversible and permanent signal changes
- Multidisciplinary team working
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. |
| # 3 |
Outcome
Record free running and/or triggered electromyography during intraoperative neuromonitoring for spinal surgery. |
| # 4 |
Outcome
Identify and respond to factors that impact intraoperative neuromonitoring for spinal surgery including technical problems and physiological effects. |
| # 5 |
Outcome
Identify, communicate and document relevant changes noted in intraoperative neuromonitoring for spinal surgery. |
| # 7 |
Outcome
Demonstrate effective and professional communication skills with the multidisciplinary theatre team. |