Electrical safety in electrodiagnostic medicine

Enhancing safety during procedures is one of our primary professional obligations to our patients. The vigilant application of basic principles allows electrodiagnostic medicine consultants to maintain a safe environment for both patients and office staff. Use of a nerve stimulator in close proximity to the path of wires or catheters that enter the heart or great vessels should be avoided; a separation of at least 15 cm (6 in) is recommended. Other testing of nerves in the limbs can be performed safely, particularly in patients with modern bipolar pacemakers and even with cardiac defibrillation devices in place. Current must never have a path to flow through the torso. Proper grounding of electrodiagnostic equipment should be ensured, and both the instruments and the wall plugs should be tested periodically. In addition, adherence to the proper stimulation intensity and avoidance of overstimulation is important not only for safety but also because it improves measurement accuracy and patient comfort.