ELECTRONEURODIAGNOSTIC TECHNOLOGIST

Electroneurodiagnostic technologists help physicians diagnose brain tumors, strokes, toxic/metabolic disorders, epilepsy and sleep disorders. They also measure the effects of infectious diseases on the brain, as well as determine whether individuals with mental or behavioral problems have an organic impairment such as Alzheimer's disease. Furthermore, they determine "cerebral" death, the absence of brain activity, and assess the probability of recovery from a coma.

Electroneurodiagnostic technologists who specialize in basic or "resting" EEG's, are called EEG technologists. The range of tests performed by electroneurodiagnostic technologists is broader than, but includes, those conducted by EEG technologists. Because it provides a more accurate description of work typically performed in the field, the title electroneurodiagnostic technologists generally has replaced that of EEG technologist.

Electroneurodiagnostic technologists take patients' medical histories and help them relax, then apply electrodes to designated spots on the patient's head. They must choose the most appropriate combination of instrument controls and electrodes to correct for mechanical or electrical interferences that come from somewhere other than the brain, such as eye movement or radiation from electrical sources.

Increasingly, technologists perform EEG's in the operating room, which requires that they understand anesthesia's effect on brain waves. For special procedure EEG's, technologists may secure electrodes to the chest, arm, leg or spinal column to record activity from both the central and peripheral nervous systems.

In ambulatory monitoring, technologists monitor the brain, and sometimes the heart, while patients carry out normal activities over a 24-hour period. They then remove the small recorder carried by the patients and obtain a readout. Technologists review the readouts, selecting sections for the physician to examine.

Using "evoked potential" testing, technologists measure sensory and physical responses to specific stimuli. After the electrodes have been attached, they set the instrument for the type and intensity of the stimulus, increase the intensity until the patient reacts and note the sensation level. The tests may take from 1 to 4 hours.

For nerve conduction tests, used to diagnose muscle and nerve problems, technologists place electrodes on the patient's skin over a nerve and over the muscle. Then they stimulate the nerve with an electrical current and record how long it takes the nerve impulse to reach the muscle.

Technologists who specialize in and administer sleep disorder studies are called polysomnographic technologists. The sleep studies are conducted in a clinic called a "sleep center." During the procedure, technologists monitor the patient's respiration and heart activity in addition to brain wave activity and must know the dynamics of the cardiopulmonary systems during each stage of sleep. They coordinate readings from several organ systems, separating them according to the stages of sleep and relay them to the physician. For quantitative EEG's, technologists decide which sections of the EEG should be transformed into color-coded pictures of brain wave frequency and intensity for interpretation by a physician. They may also write technical reports summarizing test results.

Technologists also look for changes in the patient's neurologic, cardiac and respiratory status, which may indicate an emergency such as a heart attack, and provide emergency care until help arrives.

Electroneurodiagnostic technologists may have supervisory or administrative responsibilities. They may manage an eletroneurodiagnostic laboratory, arrange work schedules, keep records, schedule appointments, order supplies, provide instruction to less experienced technologists and may also be responsible for equipment upkeep.

Electroneurodiagnostic technologists usually work in clean, well-lighted surroundings and spend about half of their time on their feet. Bending and lifting are necessary because they may work with patients who are very ill and require assistance. Technologists employed in hospitals may do all their work in a single room or push equipment to a patient's bedside and obtain recordings there.

Most technologists work a standard work week, although those in hospitals may be "on call" evenings, weekends and holidays. Those performing sleep studies usually work evenings and nights.

Technologists should have manual dexterity, good vision, writing skills, an aptitude for working with electronic equipment, and the ability to work with patients and other health personnel.

Although most electroneurodiagnostic technologists currently employed learned their skills on the job, employers are beginning to favor those who have completed formal training. Some hospitals require applicants for trainee positions to have postsecondary training while others only expect a high school diploma. Recommended high school and college subjects for prospective technologists include health, biology, anatomy and mathematics. Often, on-the-job trainees are transfers from other hospital jobs, such as licensed practical nurses.

Formal postsecondary training is offered in hospitals and community colleges. In 1996, the Joint Review Committee on Education in Electroneurodiagnostic Technology had approved 11 formal programs. Programs usually last from 1 to 2 years and include laboratory experience as well as classroom instruction in human anatomy and physiology, neurology, neuroanatomy, neurophysiology, medical terminology, computer technology, electronics and instrumentation. Graduates receive associate degrees or certificates.

The American Board of Registration of Electroencephalographic and Evoked Potential Technologists awards the credential "Registered EEG Technologist," "Registered Evoked Potential Technologist," and "Certificate in Neurophysiologic Intraoperative Monitoring" to qualified applicants. The Association of Polysomnographic Technologists registers polysomnographic technologists. Applicants interested in taking the registration exam must have worked in a sleep center for at least 1 year. Although not generally required for staff level jobs, registration indicates professional competence and is usually necessary for supervisory or teaching jobs. In addition, the American Association of Electrodiagnostic Technologists provides certification in the field of nerve conduction studies for electroneurodiagnostic technologists.

Experienced electroneurodiagnostic technologists can advance to chief or manager of a electroneurodiagnostic laboratory. Chief technologists are generally supervised by a physician—an electroencephalographer, neurologist or neurosurgeon. Technologists may also teach or go into research.

According to a Hay Group survey of acute care hospitals, the median annual base salary of full-time EEG technologists was $26,800 in January 1997. The middle 50 percent earned between $23,200 and $30,100.

Electroneurodiagnostic technologists held more than 6,400 jobs in 1996. Most worked in neurology laboratories of hospitals, while others worked in offices and clinics of neurologists and neurosurgeons, sleep centers and psychiatric facilities.

Job prospects for qualified applicants are expected to be good. Employment of electroneurodiagnostic technologists is expected to grow faster than the national average for all occupations through the year 2006, reflecting the increased numbers of neurodiagnostic tests performed. There will be more testing as new procedures are developed and as the size of the population grows. A very low number of openings each year are expected, however, because the occupation is very small. Most jobs will be found in hospitals, but growth will be fastest in offices and clinics of neurologists.