Traveling Surgical Neurophysiologist

PURPOSE OF THE POSITION

Travel exclusively to accounts across a region to provide intraoperative neurophysiological monitoring (IONM) care for patients during surgical procedures where there is risk of neurologic injury. Detect early signs of potential or evolving injury so that steps may be taken during surgery to reduce the risk of postoperative neurologic deficit. Provided services may include testing with evoked potentials, electromyography, electroencephalography, nerve conduction studies and/or other modalities.

Travel assignments may vary in length.

• Travel to an assigned account for the specified period of time to perform IONM services.
• Support local market sites when not traveling for the region with IONM services as needed.
• Explain test procedures so they are understandable to the patient and any family members who are present.
• Identify oneself appropriately and makes the patient and/or family relaxed and confident in understanding the role of the surgical neurophysiologist.
• Apply stimulation and recording electrodes in an accurate and timely manner.
• Perform initial clinical motor and sensory neurological assessment and incorporates results into expectations or changes in monitoring protocols.
• Consult with anesthesia team regarding management of anesthetic agents for successful recording of neurophysiological signals.
• Review the patient medical record, x-rays, MRI scans and clinical history to determine appropriateness of the monitoring.
• Prepare patient for neurophysiological monitoring by applying electrodes in the holding area and/or in the operating room.
• Calibrate, evaluate and adjust equipment, optimizing stimulation and recording parameters to acquire salient data.
• Set up neurophysiological equipment following any indicated biomedical electrical safety checks, with equipment properly located in operating room and assembled with respect to reduction of recording artifact.
• Establish and prepare medical record documentation in accordance with hospital and Specialty Care policy.
• Implement appropriate troubleshooting methods, such as adjusting stimulation and recording parameters to collect accurate information.
• Keep equipment clean and in proper working order, reporting malfunctions to supervisor and/or biomedical engineering department and/or manufacturer.
• Communicate and document potential or real equipment problems to all relevant members of the clinical team.
• Establish and maintain timely communication with other members of the neuromonitoring team who may be providing professional oversight and/or consultation during surgery.
• Interact with surgeons and other members of the surgical team to provide interpretive data regarding the patient’s neurological status during the procedure.
• Identify and eliminate physiological and non-physiological artifacts in recordings.
• Recognize normal patterns, normal variants, and abnormal patterns in neurophysiological recordings.
• Understand the medical and pharmacological/anesthetic conditions that influence neurophysiological recordings.
• Understand the clinical correlations between abnormal evoked potentials and various pathological states.
• Record, troubleshoot, identify and interpret obligate neurophysiological signals, and reports to the surgical team with options for specific interventions when necessary (e.g. stop surgery, wait and raise blood pressure, initiate methylprednisolone protocol, temporary break from surgery, remove instrumentation, etc.)
• Communicate neurophysiological changes to the surgical team, providing a technical description of the monitoring recordings as needed.
• Performs post-operative clinical follow-up, and provides follow-up recording as needed.
• Disconnect the electrodes from the patient following surgery and disassembles equipment.
• Follow Specialty Care needle and safety practices.
• Display, label and print waveforms to electronic copy for interpretation and/or archiving.
• Calculate measures such as evoked potential latency and amplitude following established guidelines and protocols.
• Prepare accurate and timely IONM logs, files and work/technical sheets, including a technical description of the IONM modalities, with…