Before you start testing, instruct the patient to turn off all their electronic devices in order to minimize noise.
Now, look in your patient's ear to ensure no excess cerumen is present.
Clean the patient's skin on the high and low forehead and behind each ear on the mastoid.
Wipe off any excess abrasive gel and place your four electrodes.
If doing bone conduction, you can place the electrodes lower on the mastoid.
Connect the electrode cables.
You can twist the cables to help the common mode rejection and improve results.
Now, test the impedance.
Impedances below five kiloohms are acceptable.
It is important that there is no more than two kiloohms of imbalance in impedances between electrodes.
Insert transducers and start testing.
During the test, the patient should relax with their eyes closed and even go to sleep, if possible, as this will improve results.