Well, I guess I'll answer. I just took two very intensive summer courses at Harvard. One of them, an upper level brain science class, was taught by a full professor of neurology at the Harvard Med School. In this class we were formally introduced and educated on EEG and the many types of EEGs there are. We learned the history, equipment, use, clinical applications and research applications. We went to the Electrophysiology Lab at Beth Israel Deaconess Medical Center (a Harvard hospital) and spent a lot of time with Dr Drislane and his staff in learning how to use and research/clinical applications of EEG. We had actual volunteer test patients whom we hooked up to many different types of EEGs and ran many tests on them, including exposing them to strobe lights, doing vision (VEP) and audio (AEP) exams on them. Also had them hyperventilate for 5 minutes while we recorded their brain waves. We had to become very well versed in reading and interpreting EEG wave patterns. Knowing how to see the different of alpha, beta and theta waves, what parts of the brain conduct them, the exact electrodes which cause them, the brain electrical pathways involved in the conduction, the areas of the neocortex involved, etc. Then we had to write professional written, graduate level research papers on the EEG, AEP and VEPs, with many, many pubmed references.
I can go on, but I think I satisfied your requirement of having formal education and not merely reading things "online".
Couldn't agree more. Putting an EEG cap on someone with a broken foot is inappropriate. We both likely agree on that.
Like all pieces of equipment, there are appropriate times to use them and inappropriate times to use them. It's just another "tool in the toolbox".
Absolutely incorrect. But the same can be said about ECG.
Please see my response above. If formal education at my university from a full professor of neurology doesn't count then I am not sure what does.
A whole two weeks? Are we supposed to be impressed by that? I took a two week course on digital photography and I still can not claim to be an expert.
You also seem to have attended a very specialized lecture which covered not basics so you seem to have gotten just a very small paragraph out of a very large book on this subject. This lecture would probably have made more sense if you had actually taken an introductory course first. Again, you are speaking with ZERO training, ZERO experience and with a very large part of the EEG education missing.
EEG is now a two year degree for just the entry level technician. EEG is also under the RT department is some hospitals and for years, RTs were cross-trained to perform them. However, it was soon realized it was a serious speicality and those that wanted to do EEGs had to complete the necessary educational requirements to sit for the Registry exam for EEG. The same for those doing Sleep Lab now which also utilizes EEGs.
It took almost 60 years for a CPAP device to be developed that could be used in the field and unfortunately even some of those are just half-arsed adequate. Why do you think the computers you use on the ambulance are "Toughbooks"? Do you actually think the EEG machine will do well stored in a truck at 100 or -10 degree temps and while being jostled around? Would you even trust the realibilty of it under those conditions?
EEGs are generally performed under idea situations to assure accuracy. If I am treating according to the diagnostic test, I want to be certain there are is no guessing involved. Like you mentioned the filters on the EKG, they also have their limitations and will not correct for bad lead placement, bad connections and artifact of a moving patient or truck. (see usafmedic45's post)
We also discussed the ultrasound on this forum and that also could have its place on an ambulance but only if warranted for choosing a trauma center at great distances. We had the US on the helicopter for awhile but realized it was not playing a huge role in determining either our treatment or destination. You also must consider the differences between ruling out and ruling in. Many tools are only good in the field for confirming what you already suspect. I could use the pulse ox as an example. If the person is blue and stating they are short of breath, do you really need the pulse ox to confirm that?
Like the EKG, the EEG reflects electrical activity. There are still many other issues within the head that must be considered. An EEG alone may not tell the surgeon where to cut before the skull is opened but it might be very useful once the skull is open. Our EEG technologists are often present in the OR.
You again are missing the part of an integrated system with the appropriate technology at all ends. You will have to transmit the data and the facility or person, who is qualified in neurology, rec'g this data would have to have the technology at their access. If they already receive from the hospitals using one piece of equipment, are you going to be able to adapt your equipment to theirs? The transmitting of 12-leads makes national headlines for some services. This is even an issue with adapting the pads on the EKG machines from one ambulance or facility to each other. Also, the transmission carrier is not infallible. There will be occasional interuptions at each end.
You are also going to need a couple of CAPs that cost between $500 - $1000/each, an amplifier, a reliable computer, the software, impedance meter and interface cables. While it may only take 5 seconds to put on the CAP, how long did it take them to connect the other equipment, run the start up program and initiate the proper impedance? Even the time it takes to start up a computer and intiate the program takes time.
I am all for adding more skills but only if the base knowledge is there and if it will make a difference for the patient. I already made my point with EKGs and "cheap skill" by using those who only place electrodes and rely on the machine interpretation.
We do research also with EEGs but we also do a lot of research in conjunction with the MRI and CT Scan. For head trauma or CVA, it would be nice if all it took was putting a cap on someone and pinpointing the exact problem. But, we are dealing with humans what not all disease processes just fit nicely into a couple of diagnoses.
