Troubleshooting from a Distance

As an EEG Technologist you have to learn to troubleshoot to give the best monitoring possible. When you are in the hospital you may need to unplug the bed or IV pole. Maybe you have to take an electrode off, rescrub the spot, and put it back on. What do you do when you are watching patients remotely often times from several states away? This is when troubleshooting has limitations and we try everything in our power to resolve the issues through a knowledge base and sequential process of elimination.

Being familiar with equipment

A technologist's familiarity with the equipment and technology being used becomes critical when you are trying to troubleshoot from a distance. You may need to call the nursing staff and be as clear as possible with your explanations. A perfect example is when using Natus Xltek equipment and it shows that the headbox is unplugged. I will explain to staff that the gray "phone" cord plugs into the box connected to the electrodes on their head. Unfortunately, we don't often have a perfect example and easy to explain solution. This is why having a firm grasp of the equipment can be so helpful. Many of the on site staff such as nurses and nursing techs will not likely be familiar with our equipment so we must try to explain it specifically to the best of our ability using basic descriptions of locations, port types, wire routing, and more.

XLTEK Headbox

Poor electrode quality

Not being on-site to fix electrodes means you must learn to utilize the tools you are given and know when you need to call on local staff. Since our Continuous Monitoring Department monitors patients for multiple clients and facilities we have established criteria to best monitor based on their preferences and needs. Some facilities may choose that if a patient pulls off an electrode overnight that we hide the affected channels so they don't obscure the rest of the data. While other facilities may choose to have us decrease the sensitivity on affected channels. Adjusting filters and hiding channels may be fine since we are monitoring through the database versus permanently changing the record. If there are local staff members on-site 24/7 versus being on-call they may prefer to be notified. Lastly, tolerance of poor electrode quality is ultimately up to the reading epileptologist, so the protocols are ultimately driven by their clinical directives.

Patient having EEG electrodes applied to head.

Being a monitoring technologist it is vital that we stay up-to-date with any and all facility preferences. The criteria may change regularly so consulting your Continuous Monitoring Department client profiles for every client for every shift to identify updates is essential. This is incredibly important to check because one facility may want us to call for each electrode that a patient pulls off and another may have us wait until a certain number are removed. We work to the best of our ability to be able to provide the patients with the best test within the limitations we are given.

Logins & Servers & Citrix, Oh My!

I can't talk about troubleshooting from a distance without talking about the possible technical issues that can occur. We monitor patients through the facilities preferred secure connection. Sometimes we may run into issues and if it is a known issue with a known solution we work around it to give the best patient care. At times we run into issues on the hospital side of technology and that is when we may need to contact their hospital IT or local staff. As a department we exhaust all resources and utilize our chain of leadership to troubleshoot technical issues. In the rare times that technical issues can not be overcome our leadership works with the facilities' leadership and IT department to have future solutions and fixes in place.

We have worked hard with the Integris Neuro IT department to make sure the monitoring technologists have equipment to meet our needs. We have gone so far as to make sure full time techs have battery backups and internet hotspots in the rare chance that our power or hardline internet is negatively affected at any time.

Teamwork

I would say the best way our staff is able to troubleshoot from a distance is by using teamwork. We work together with local neurodiagnostic, nursing staff, and IT to take care of our patients. Our staff works together each shift to help troubleshoot problems and be better prepared as new issues arise. We try to continue to use the information we learn today to help us solve the problems of tomorrow.