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

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PULSE ARTIFACT

P7… Seizure or artifact?

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Note EKG variability

TROUBLESHOOTING PULSE ARTIFACT

* Observe/Identify compare to EKG channel

* Move Electrode if appropriate* Document!

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SNORE ARTIFACT

SNORE SNORE

TROUBLESHOOTINGSNORE ARTIFACT:

*Observe/Identify*Reposition if Possible*Document*Monitor

NEXT SAMPLE:

EEG OR ARTIFACT??

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HEAD SCRATCHING

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PT SCRATCHING BACK OF HEAD

HEAD SCRATCHING

NEXT SAMPLE:

EEG OR ARTIFACT??

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EMG

RIGHT HEMIFACIAL SPASM

EMG

RIGHT FACIAL TWITCHES

TROUBLESHOOTINGEMG ARTIFACT:

*Identify the issue*Observe/Document*Relax the patient if tense*Monitor

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SWALLOWING ARTIFACT

NEXT SAMPLE:

EEG OR ARTIFACT??

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CHEWING ARTIFACT

NEXT SAMPLE:

EEG OR ARTIFACT??

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TREMOR ARTIFACT

EMG CHANNEL

MONITORINGTREMOR ARTIFACT

TROUBLESHOOTINGEMG ARTIFACT:

*Identify/Observe*Document any mvts*Correct- relax if possible*Monitor if appropriate

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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??

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RESPIRATION ARTIFACT

X X X X=exhale

TROUBLESHOOTINGRESPIRATION ARTIFACT:

*Observe/Document*Reposition to eliminate*Monitor

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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!