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OVERVIEW Electroneurodiagnostic technologists, sometimes called EEG technologists or END technologists, operate electronic instruments called electroencephalographs. These instruments measure and record the brain’s electrical activity. The information gathered is used by physicians (usually neurologists) to diagnose and determine the effects of certain diseases and injuries, including brain tumors, cerebral vascular strokes, Alzheimer’s disease, epilepsy, some metabolic disorders, and brain injuries caused by accidents or infectious diseases. HISTORYThe brain constantly discharges small electrical impulses. These vibrations can be picked up from the surface of the head, amplified, and then recorded on paper. These currents were first detected in England in 1875 by Richard Caton, who used electrodes on the exposed brains of rabbits and monkeys. The resulting picture of electrical brain activity, usually called a tracing, became known as an electroencephalogram. Other researchers independently studied this brain activity in the late 1800s and early 1900s. In 1929, the German Hans Berger developed the first electroencephalograph to be used on human beings. In the mid-1930s, electroencephalograms were developed to diagnose epilepsy. Shortly afterward, they were used to locate brain tumors. By the end of the 1930s, a new field had opened up through which doctors and technicians could better diagnose and treat neurological disorders. THE JOB The basic principle behind electroencephalography (LEG) is that electrical impulses emitted by the brain, often called brain waves, vary according to the brain’s age, activity, and condition. Research has established that certain brain conditions correspond to certain brain waves. Therefore, testing brain waves can aid the neurologist (a physician specially trained in the study of the brain) in making a diagnosis of a person’s illness or injury. The EEG technologist’s first task with a new patient is to take a simplified medical history. This entails asking questions and recording answers about his or her past health status and present illness. These answers provide the technologist with necessary information about the patient’s condition. They also provide an opportunity to help the patient relax before the test. The technologist then applies electrodes to the patient’s head. Often, technologists must choose the best combination of instrument controls and placement of electrodes to produce the kind of tracing that has been requested. In some cases, a physician will give special instructions to the technologist regarding the placement of electrodes. Once in place, the electrodes are connected to the recording equipment. Here, a bank of sensitive electronic amplifiers transmits information to writing instruments. Tracings from each electrode are made on a moving strip of paper or recorded on optical disks in response to the amplified impulses coming from the brain. The resulting graph is a recording of the patient’s brain waves. LEG technologists are not responsible for interpreting the tracings—that is the job of the neurologist. However, EEG technologists must be able to recognize abnormal brain activity and any readings on the tracing that are coming from somewhere other than the brain, such as readings of eye movement or nearby electrical equipment. Technologists can make recording changes to better present the abnormal findings for physician interpretation. Stray readings are known as artifacts. Technologists must be able to determine what kinds of artifacts should be expected for an individual patient on the basis of the patient’s medical history or present illness. Technologists should also be sensitive to these artifacts and be able to identify them if they occur. Technologists must he able to detect faulty recordings made by human error or by machine malfunctions. When mechanical problems occur, technologists should notify their supervisors SO that trained equipment technicians can be called to repair the machine. Throughout the procedure, electroneurodiagnostic technologists observe the patient’s behavior and make detailed notes about any aspect of the behavior that might be of use to the physician in interpreting the tracing. They also keep watch on the patient’s brain, heart, and breathing functions for any signs that the patient is in any immediate danger. During the testing, the patient may be either asleep or awake. In some cases, the physician may want recordings taken in both states. Sometimes the physician prescribes drugs or special procedures to simulate a specific kind of condition. Administering the drugs or procedures is often the technologist’s responsibility. EEG technologists need a basic understanding of any medical emergencies that can occur during this procedure. By being prepared, they can react properly if one of these emergencies should arise. For instance, if a patient suffers an epileptic seizure, technologists must know what to do. They must be flexible and able to handle medical crises during procedures. EEGs are increasingly used on a routine basis in the operating room to monitor patients during major surgery. EEG technologists may also handle other specialized electroencephalograms. For example, in a procedure called ambulatory monitoring, heart and brain activities are tracked over a 24-hour period by a small recording device on the patient’s side. In evoked potential testing, a special machine is used to measure the brain’s electrical activity in response to specific types of stimuli. In nerve conduction studies, technologists stimulate peripheral nerves with an electrical current and record how long it takes the nerve impulse to reach the muscle. The polysomnogram is a procedure that uses EEG and other physiologic monitors to evaluate sleep and sleep disorders. Besides conducting various kinds of electroencephalograms, EEG technologists also maintain the EEG machine, perform minor repairs (major repairs require trained equipment technicians), schedule appointments, and order supplies. In some cases, technologists may have some supervisory responsibilities; however, registered electroencephalographic technologists take on most supervisory responsibilities. REQUIREMENTS High School You must have a high school diploma for entry into any kind of EEG technologist training program, whether in school or on the job. In general, you will find it helpful to have three years of mathematics (including algebra) and three years of science (including biology, chemistry, and physics). In addition, you should take courses in English, especially those that help improve communication skills, and in social sciences so that you can better understand the social and psychological needs of your patients. Postsecondary Training There are two main types of postsecondary training available for EEG technologists: on-the-job training and formal classroom training. Many technologists who are currently working received on-the-job training; however, EEG equipment is becoming so sophisticated that many employers prefer to hire EEG technologists with prior formal training. On-the-job training generally lasts from a few months to one year, depending on the employer’s special requirements. Trainees learn how to handle the equipment and carry out procedures by observing and receiving instruction from senior electroencephalographic technologists. Formal training consists of both practice in the clinical laboratory and instruction in the classroom. The classroom instruction usually focuses on basic subjects such as human anatomy, physiology, neuroanatomy, clinical neurology, neuropsychiatry, clinical and internal medicine, psychology, electronics, and instrumentation. The curriculum also includes EEG, evoked potentials, and at least an introduction to nerve conduction and polysomnography. The post- secondary programs usually last from one to two years, offering either a certificate or associate’s degree upon completion. Hospitals, medical centers, and community or technical colleges offer these courses. Currently there are 12 schools with accredited two-year pro grams. According to the American Society of Electroneurodiagnostic Technologists, by 2005 anyone entering the END profession will be required to have an associate’s degree or higher and have successfully completed an accredited program reviewed by the Joint Review Committee on Education in Electroneurodiagnostic Technology. Students who have completed one year of on-the-job training or who have graduated from a formal training program may apply for registration. Certification or Licensing The American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET) offers certification as a registered electroencephalographic technologist (REEGT). Although registration is not required for employment, it is an acknowledgment of the technologist’s training and does make ad advancement easier. Registration may also provide a salary increase. Other Requirements EEG technologists need good vision and manual dexterity, an aptitude for working with mechanical and electronic equipment, and the ability to get along well with patients, their families, and members of the hospital staff. To be a successful technologist, you must be good with people, quickly recognize what others may be feeling, and personalize treatment to the individual patient’s needs. You need to be able to realize that some patients will be very ill, even in the process of dying. EXPLORING Prospective EEG technologists will find it difficult to gain any direct experience on a part-time basis in electroencephalography. Your first direct experience with the work will generally come during on-the- job training sessions or in the practical-experience portion of your formal training. You may, however, be able to gain some general exposure to patient-care activities by signing up for volunteer work at a local hospital. In addition, you can arrange to visit a hospital, clinic, or doctor’s office where electroencephalograms are administered. In this way, you may be able to watch technologists at work or talk to them about what the work is like. EMPLOYERS Electroneurodiagnostic technologists typically find work in hospitals, medical centers, clinics, and government agencies that perform EEGs. STARTING OUT Technologists often obtain permanent employment in the hospital where they received their on-the-job or work-study training. You can also find employment through classified ads in newspapers and by contacting the personnel offices of hospitals, medical centers, clinics, and government agencies that employ EEG technologists. ADVANCEMENT Opportunities for advancement are good for registered EEG technologists. Those without registration will find opportunities for advancement severely limited. Usually, registered electroneurodiagnostic technologists are assigned to conduct more difficult or specialized electroencephalograms. They also supervise other electroencephalographic technologists, arrange work schedules, and teach techniques to new trainees. They may also establish procedures, manage a laboratory, keep records, schedule appointments, and order supplies. EEG technologists may advance to chief electroencephalographic technologists and thus take on even more responsibilities in laboratory management and in teaching new personnel and students. Chief electroencephalographic technologists generally work under the direction of an electroencephalographer, neurologist, or neurosurgeon. EARNINGS According to the American Society of Electroneurodiagnostic Technologists, salaries range from $25,000 for new graduates of END programs to more than $70,000 for lab managers of independent contractors. The average salary for all END technologists was $37,853 in 2000. Earnings depend on education, experience, level of responsibility, type of employment, and geographical region. Salaries for registered EEG technologists tended to be higher than nonregistered technologists with equivalent experience. The highest salaries for EEG technologists tend to go to those who work as laboratory supervisors, teachers in training programs, and pro gram directors in schools of electroencephalographic technology. Technologists working in hospitals receive the same fringe benefits as other hospital workers, usually including health insurance, paid vacations, and sick leave. In some cases, the benefits may also include educational assistance, pension plans, and uniform allowances. WORK ENVIRONMENT EEG technologists usually work five-day, 40-hour workweeks, with only occasional overtime required. Some hospitals require them to be on call for emergencies during weekends, evenings, and holidays. Technologists doing sleep studies may work most of their hours at night. EEG technologists generally work with people who are ill and may be frightened or emotionally disturbed. As a result, work can be unpredictable and challenging. Most EEG technologists are employed by hospitals, where the work can vary greatly. In emergency situations, the work is often stressful and hectic as they work closely with other staff members. At other times, conditions are calmer. The EEG technologist often works independently with a patient, spending much time in a darkened room during the tests. OUTLOOK Employment of electro-neuro-diagnostic technologists is expected to grow more slowly than the average, primarily because of new procedures and technologies that require fewer workers to do the same amount of work. Also, hospitals’ use of cross-trained employees to cover many jobs will further diminish the need for specially trained technologists. The slow growth should be offset somewhat by population growth and an increase in the use of electroencephalographs in surgery, diagnosis, monitoring, and research. There is some promise of employment for END technologists in the area of polysomnography and long-term monitoring for epilepsy and intraoperative monitoring. FOR MORE INFORMATION For information and an application to start the EEG or Evoked Potential examination process, contact American Board of Registration of Electroencephalographic and Evoked Potential Technologists 1904 Croydon Drive Springfield, IL 62703 Tel: 217-553-3758 Email: abreteo@aol.com For a career brochure and information about scholarships and educational opportunities, contact American Society of Electroneurodiagnostic Technologists 428 West 42nd Street, Suite B Kansas City, MO 64111 Tel: 816-931-1120 Email: info@aset.org For information on polysomnograms and sleep disorders, contact Association of Polysomnographic Technology PO Box 14861 Lenexa, KS 66285-4861 Tel: 913-541-1991 For information on accredited training programs, contact Joint Review Committee on Electroneurodiagnostic Technology Route 1, Box 63A Genoa, WI 54632 Tel: 608-689-2058 Next: Emergency Medical Technicians Prev.: Dietetic Technicians |
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