ACNS Guidelines 2023 UPDATE

ACNS Guidelines 2023 UPDATE There should be a _____ limit on total chassis leakage, and ______ limit for isolated patient connections - ANSWER 100 µA , 10 µA The grounding system should ensure that no voltage greater than ______ can be measured across an impedance of 1,000 ohms, typically at 60 Hz, between any combination of exposed conductive surfaces or grounding conductors that may be in contact with the patient or personnel - ANSWER 20 mV rms A __________should be in place to detect leakage or fault current to ground - ANSWER line isolation monitor All NIOM systems must be inspected: - ANSWER before use and at least twice a year. Nitrous oxide and halogenated inhalational agents, for example, may substantially attenuate transcranial electrical motor evoked potentials (TceMEPs) recorded over muscles. These agents also attenuate the cortical components of SEP somatosensory evoked potentials (SEPs); this effect can be particularly prominent for: - ANSWER lower extremity SEPs and in young children. What components are less affected by Nitrous oxide and halogenated inhalation agents? - ANSWER Subcortical components Neuromuscular blocking agents, however, interfere with monitoring of _____ , ______ and ____ - ANSWER spontaneous EMG, compound muscle action potentials (CMAPs), and muscle TceMEPs. During thoracic spinal cord surgery, for example, systemic effects would be expected to affect both upper and lower extremity muscle TceMEPs and SEPs, whereas local manipulation would only be expected to alter: - ANSWER lower extremity muscle TceMEPs and SEPs. Baseline values for NIOM data are established following _________________ but prior to ______________ - ANSWER induction of anesthesia and positioning of the patient , surgical intervention.