Technical tips: verification of accurate placement and labeling of 10-10 scalp electrodes and intracranial grid/strip...

In some instances, evaluation of seizure activity may require the addition of 10-10 scalp electrodes or the placement of intracranial grids and strips. At any given time, different technologists may be responsible for placement, addition, and the care of electrodes for the same patient. The presence of extra surface electrodes or extensive coverage of brain with intracranial electrodes increases the risk of incorrect placement and labeling which can cause treatment errors based on inaccurate reading of EEG recordings. Procedures should be put into place with documentation tools to correctly place, label, and hook-up extra 10-10 scalp and intracranial electrodes without errors. By using written processes and documentation tools, staff are more capable of acquiring safe and accurate patient data which increase good patient outcomes. The processes for placement and hook up of 10-10 scalp electrodes and intracranial grid and strip electrodes are different and require separate procedures and documentation tools to ensure accuracy. For 10-10 scalp electrode placement, the use of a 10-10 map, labeled tape, and non-duplicating adjacent electrode colors reduces risk of error Documentation of intracranial grid/strip electrodes includes placement map, list of electrode locations in amplifier and a table of cables and corresponding grid/strips with colors. Accurate hook-up is verified by the technologist and the epileptologist and is documented on recording. With the use of documentation tools and verification procedures, the quality of patient outcomes increases while the potential for recording errors is reduced.