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The NIM™ 3.0 is intended for locating and identifying cranial and peripheral motor and mixed motor-sensory nerves during surgery, including spinal cord and spinal nerve roots. The APS™ electrode is an accessory intended for providing automatic periodic stimulation to nerves when used with the Medtronic nerve monitoring systems.
The use of paralyzing anesthetic agents will significantly reduce, if not completely eliminate, EMG responses to direct or passive neural stimulation.
Be careful not to damage vascular structures when preparing the nerve for the installation of the APS™ electrode.
EMG amplitude may be affected by anesthesia regimen used. Consult anesthesiologist if EMG changes are observed.
Remove APS™ electrode from patient prior to using external defibrillator to prevent thermal injury to patient at APS™ electrode site.
Safe stimulus levels are dependent on various conditions including but not limited to: type of excitable tissue, charge per pulse, and charge per unit area. Waveform morphology, repetition rate, and stimulator effective surface area must be considered. It is also important to ensure proper contact of the stimulating electrode and recording electrode before increasing stimulus settings.
When exceeding recommended APS™ stimulation settings special operator attention is required. Raising current above recommended parameters may result in charge density high enough to cause nerve damage.