IOM Specialist

GENERAL SUMMARY/ OVERVIEW STATEMENT 

Under the direction of the Chief OR Technologist and the Medical Director, performs standard and complex intraoperative neurodiagnostic procedures as described by MGH Neuro Intraoperative Monitroing protocols. Under the supervision of an experienced technologist, this technologist provides troubleshooting and technical interpretation of intraoperative neurologic data during surgery to the Medical Director and to the surgical team.  The technologist is also responsible for the accurate recording and documentation of SSEP, TcMEP, EMG/Triggered EMG, BAEP, and EEG waveforms. In addition, the technologist will also be responsible for recording and the documentation of cortical motor/sensory mapping, ECoG, and direct peripheral nerve stimulation cases. The technologist also assists in the maintenance of equipment, patient data, and supplies as directed by the chief IOM technologist.  This person will act as an interactive part of the operating room team, assisting in duties as appropriate.  As MGH continues to research and apply intraoperative monitoring methods and techniques to new procedures, technologists will be required to learn new protocols as they are developed and may be asked to participate in the development of these protocols.  Technologist also displays leadership qualities and is able to identify potential areas of concern and communicate these concerns with the chief technologist.  This role also functions on a more independent basis, requiring less support from other staff members.  Technologist may be asked by the chief technologist to organize the IOM schedule, organize coverage of cases by vendors, and organize scheduling of the days cases.

PRINCIPAL DUTIES AND RESPONSIBILITIES 

Provides intraoperative monitoring for all surgical cases as requested.  This technologist works idepently requires very little assistance with the exception of complex cases and troubleshooting. Required assistance will also be determined by the medical director and chief technologist.

Throughout the surgical procedure the technologist must be able to provide continuous on-line technical interpretation to the surgical and NIOM teams. Technologist also directs the surgeon in application of sterile electrodes and stimulating devices in surgical field.

Assures that the interpreting neurophsiology physician is notified of potential issues. When possible, assures the real-time remote monitoring system is available.

Responsible for preparing patients prior to draping for surgery, setting up for all possible appropriate monitoring procedures. Preparation is by applying scalp electrodes (using the international 10-20 system and collodion glue), other electrodes and stimulators with the utmost accuracy and security, as necessary for long duration and sensitive surgical procedures.  Measures the electrical impedance and determines the integrity of all monitors, prior to the draping of the patient.

Informs the patient about the neurodiagnostic procedure and answers questions as appropriate.  Abstracts relevant clinical information from the patient's chart, the patient and from the surgeon when necessary.

Prepares a preliminary technical report describing the recording throughout the procedure. While monitoring, meticulously documents all surgical and related procedures and communications with the surgical team.

Assists in the maintenance of databases and patients' permanent documents.

Assists in the training of Technologist I-II and/or physicians as appropriate and determined by chief technologist. Technologist also serves as a role model for other technologists.

Must have a very good knowledge of the general principles of modern anesthetic techniques and the effects of different anesthetic regimens on the respective waveforms.

Must have a very good understanding of all of the surgical procedures being performed.

Keeps abreast of current developments in the IOM field and participates in educational conferences, meetings, and/or other activities that promote continuing education.

Applies infection control standards, aseptic, and sterile techniques, with particular attention to any monitoring instrumentation that enters the sterile field.

Technologist understands the policies and procedures related to "on call" status and is able to reliably take call.

May be called upon to act as charge tech in the absence of the chief technologist and senior specialist. This includes organizing the IOM schedule, ensuring coverage for all cases. Also included in this responsibility is the coordination of vendors (according to policy), and recognizing appropriate cases for team members skill level.

Consults with senior specialist and chief technologist regarding complicated issues, as requested.

SKILLS & COMPETENCIES REQUIRED 

All skills and competencies of IOM Technologist and IOM Technologist II plus:

Competent use of Xltek/Natus based equipment.

Ability to learn new software applications.

Ability to function as Charge Tech in absence of Chief Tech

Ability to lead and mentor junior staff

Ability to perform complex SSEP/MEP, BAEP, and EEG independently.  Also able to perform dorsal column mapping, cortical mapping, nerve to nerve, aneurysm, cranial nerve monitoring protocols independently.

Ability to troubleshoot equipment independently, requiring assistance only on occasion.

Excellent knowledge and experience with Microsoft Office applications

Certifications

Preferred: 

• ABRET

Registrations:

Required:

• EEG or EP

Preferred: 

• CNIM

EDUCATION 

Minimum Required:

  High school diploma, GED or equivalent

Certificate :  Graduate of an accredited electroneurodiagnostic training program and/or equivalent degree

Preferred:

EXPERIENCE 

Required: Minimum of 2 years experience in NIOM

SUPERVISORY RESPONSIBILITY 

 Indirect: Function as a Charge Tech absent the Chief Tech

FISCAL RESPONSIBILITY

  Not Applicable

WORKING CONDITIONS

• Work takes place in the OR, in which a sterile environment must be maintained.
• OR temperatures are typically cooler than normal office temperatures.
• OR rooms are separated over multiple buildings and may require walking between rooms.
• Computer systems may weigh 80-100 and are mounted on carts.  Though systems are mounted, they will need to be pushed to and from operating rooms.
• May require helping OR staff members position patients. This may require some moderate and possibly more strenuous lifting. OR cases by nature may be long in duration. Position may require sitting or standing in a room for multiple hours.
• Risks associated with the handling of needles and sharp equipment.
• Risks associated with OR environment including contact with bodily fluids and infectious disease.