Intraoperative Neurophysiologic Monitoring (IONM) uses a variety of tests such as EEGs to detect potential injuries to a patient’s nervous system in real-time while undergoing surgical procedures. IONM is typically used during orthopedic spine and neurosurgical procedures but is also used during vascular, ENT, and other surgeries where the nervous system is at risk, while EEGs are not exclusively used during operations. In contrast, EEG tests are often used to detect brain abnormalities or disorders and other nerve function issues throughout the body outside of surgeries.
Whether you specialize in IONM or EEG, you can make a difference in people’s lives. Having studied and worked in both areas, I can confirm that while there’s a fair amount of overlap between the two, there are also big differences, and they’re not what you might think.
As an EEG technologist who became a Surgical Neurophysiologist, here is my take on what’s exciting about IONM:
1. The career opportunities are endless.
Studies show that the use of IONM has grown 267% in recent years. Surgeons graduating from medical school are now exposed to IONM during their residency programs and consider it standard of care. As they obtain positions at hospitals throughout the United States, they will be requesting the service and driving the need for skilled clinicians.
2. Meaningful relationships lead to development and fulfillment.
In IONM and EEG work alike, great relationships are made, but I’ve made a wider variety of more meaningful relationships in IONM. From the start of surgery, you will be communicating directly with the patient to obtain their health history so that you can make informed decisions about how to perform testing best. You will converse with Biomedical Engineering, OR managers, nurses, and hospital staff regarding equipment safety and set-up. You will speak with the surgeon about the types of monitoring he/she will require anesthesia for and how best to collaborate so that you can gather optimal signals. The professional relationships you forge with hospital and facility staff members allows for both professional and personal development.
3. You gain exposure to diverse types of surgical procedures.
It is not atypical for EEG technologists to monitor the same types of cases on the regular. With IONM, you can perform monitoring during a vast array of surgical cases performed by a wide variety of surgeons who use neuromonitoring techniques to help reduce adverse surgical outcomes.
4. Advanced challenges require an advanced skill set.
IONM clinicians are required to have an advanced understanding of anatomy and physiology. They must have knowledge and experience in performing not only EEGs (brain activity) but also very specialized modalities that monitor the central nervous system such as SSEPs, MEPs, BAERs, cranial nerve monitoring, and language mapping.
5. You make real-time decisions in a fast-paced environment.
IONM allows you to be an integral part of the fast-paced operating room environment.Unlike in typical EEG cases, where post-test results are passed on to a physician for interpretation, diagnoses, and recommendations, IONM clinicians communicate directly with a remote supervising physician throughout the surgical procedure to discuss alerts and troubleshoot issues.
6. You are the voice for patients who can’t speak for themselves.
While under anesthesia, a patient has no means of indicating that they have lost motor or sensory function. The data you collect makes it possible to detect potential problems before they arise so that the surgical team can make informed decisions to keep patients safe. The ability to be there for people when they need it most is something uniquely fulfilling that you can’t gain from many other lines of work outside of IONM.
Lisa Tapsell, R.E.T, R. EEG. T, CLTM, Surgical Neurophysiologist