EEG ARTIFACTS - rtconnection.org · compare to EKG channel ... *Correct- relax if possible *Monitor...
Transcript of EEG ARTIFACTS - rtconnection.org · compare to EKG channel ... *Correct- relax if possible *Monitor...
Amy Caccamo, R.EEG/EP T.;CLTMMedical City Dallas
EEGARTIFACTS
For every minute spent organizing,
An hourIs earned
- Benjamin Franklin
ARTIFACTS:
BIOLOGICAL NON-BIOLOGICAL
BIOLOGIC ARTIFACTScaused by the patient
BIOLOGIC ARTIFACTS
EMG and Muscle MovementChewingSwallowingTics and Tremors
CardiacECGPulse
Perspiration (Galvanic)
Glossokinetic (Tongue)
Respiration
Eye Movements Eye BlinksNystagmusEye Flutter
NON BIOLOGIC ARTIFACTS
caused by a variety of reasons, but not by the body itself
60 Hz electrical interference
High Impedance
External Devices/ie: VNS, Pacemaker
Telephone ring – uncommon in digital recording
IV drips – uncommon in digital recording
Static Electricity- uncommon with digital equipment
NON-BIOLOGIC ARTIFACTS
TROUBLESHOOTING
* Observe/Identify issue* Fix (eliminate) if possible* Monitor* Document all steps
?
PULSE ARTIFACT
P7… Seizure or artifact?
{
Note EKG variability
TROUBLESHOOTING PULSE ARTIFACT
* Observe/Identify compare to EKG channel
* Move Electrode if appropriate* Document!
{
?
{
SNORE ARTIFACT
SNORE SNORE
TROUBLESHOOTINGSNORE ARTIFACT:
*Observe/Identify*Reposition if Possible*Document*Monitor
NEXT SAMPLE:
EEG OR ARTIFACT??
?
HEAD SCRATCHING
?
PT SCRATCHING BACK OF HEAD
HEAD SCRATCHING
NEXT SAMPLE:
EEG OR ARTIFACT??
?
EMG
RIGHT HEMIFACIAL SPASM
EMG
RIGHT FACIAL TWITCHES
TROUBLESHOOTINGEMG ARTIFACT:
*Identify the issue*Observe/Document*Relax the patient if tense*Monitor
?
SWALLOWING ARTIFACT
NEXT SAMPLE:
EEG OR ARTIFACT??
?
CHEWING ARTIFACT
NEXT SAMPLE:
EEG OR ARTIFACT??
?
TREMOR ARTIFACT
EMG CHANNEL
MONITORINGTREMOR ARTIFACT
TROUBLESHOOTINGEMG ARTIFACT:
*Identify/Observe*Document any mvts*Correct- relax if possible*Monitor if appropriate
?
EYE MOVEMENTS
CORNEA (FRONT OF EYE) = POSITIVERETINA (BACK OF EYE) = NEGATIVE
POLARITY OF THE EYE
+ -
+
-
Which lead is getting a positive potential in this image?
TROUBLESHOOTINGEOG (Eye Mvt) ARTIFACT:
*Observe*Document observations*Monitor*If patient cannot help,Hold or patch the eyes
NEXT SAMPLE:
EEG OR ARTIFACT??
?
RESPIRATION ARTIFACT
X X X X=exhale
TROUBLESHOOTINGRESPIRATION ARTIFACT:
*Observe/Document*Reposition to eliminate*Monitor
?
GALVANIC SKIN (SWEAT) ARTIFACT
TROUBLESHOOTINGSWEAT ARTIFACT:*Important to address issue prior to hookup if
at all possible
*Rub skin with alcohol & dry each site prior toapplication
*Lower temperature in room/use a fan
SZ VS ARTIFACT??
PATTING BABY
BOUNCING BABY
NON-BIOLOGIC ARTIFACT SAMPLES
What is this ?
ELECTRODE POP
ELECTRODE ARTIFACT
TROUBLESHOOTINGELECTRODE POP:
*Observe*Reapply*Change electrode*Document everything!
PACEMAKER ARTIFACT
HUMAN ERROR
INCORRECT ELECTRODEPLACEMENT
* on head* in jackbox (headbox)
FT 9 and FT10 switched in headbox
L TEMP SZ ONSET
FT 10
FT9
FT 9 and FT 10 in correct jack
FT 10
FT9
L TEMP SZ ONSET
MONITORING / PROVING ERROR BY TAP TEST
FT10
TROUBLESHOOTINGHUMAN ERROR
* Identify the issue* Tap test leads/document*Correct issue/document*Notify Necessary Parties
ELECTRICAL ARTIFACTSCell phones/chargers/computers
Beds
Hospital equipment- IV’s, Vents, pumps
Anything plugged in…
Cell phone charger plugged in
Cell phone unplugged
BED (GROUND) ARTIFACT
PHONE RINGING ARTIFACT
about non-biologic artifacts
Good impedance – LOW & EQUAL
Secure application of electrodes
Keep electrodes as straight (parallel) as possible and in a neat and tidy bundle. Stray wires are like antennae!
Avoid “other peoples’” cables and equipmentwith your equipment/leads/and machine cables
Use empty outlet (if possible)
Unplug uneccesary or battery operated equipment during EEG… Make sure to ASK and plug them back in!
Bundle Leads and wrap them in a towel
If recording looks bad but hookup looks good, check the ground and/or reference.
Your text here
THANK YOU!