Training in ABR
ABR Testing: Patient Preparation
Description
This video provides a demonstration of preparing a newborn baby for threshold auditory brainstem response (ABR) testing, including skin preparation and electrode placement.
You can read the full transcript below.
Preparing the electrode sites
So hi, I'm Amanda and today I'm going to be demonstrating how to perform an auditory brainstem response test. I have a little one-month-old baby with me today. She was born full-time. She's a healthy baby and she's very kindly agreed to do some testing with us today. So we don't want to waste any time, let's get on with getting her ready.
The first thing to do is to prepare the electrode sites. So we have got the Eclipse, which is a two-channel system. So we're going to be using four electrodes today. One on the high forehead, the ground just on the low forehead, and one behind each ear. Those will be our two reference electrodes, and the high forehead will be our active.
So what we need to do is take some electrode gel and a bit of gauze. Or you could use cotton wool. Some people like to use a bit of water or an alcohol wipe before or after doing this. I personally prefer just to use electrode gel. It generally tends to be enough. You don't need much, just a small little blob and we are going to get her high forehead ready.
So you don't need to press hard, it's just about cleaning off any excess oils or dead skin cells. And you don't need to cover a huge area, you just want it to be the area that will be covered by your electrode. So if your baby has a low fontanelle, you do want to avoid that area, so you can go a little bit lower or you can go off to one side. Just be conscious of that when you come to look at your traces.
That looks good. Lovely. We'll just do the low forehead and behind each ear. So on an adult patient, you might be able to put the ground electrode on the low forehead directly underneath your active. But with most babies, you do need to go off to the side because they're so little. Now you can just turn the gauze over and use the dry side just to clean off any of that excess electrode gel.
So with your ear electrode placement, you can either go on the mastoid or on the earlobe. Most babies' earlobes are too little for that option, so we generally go behind the ear on the mastoid. You don't want to be too high up in case you need to do some bone conduction placement later. You also don't want to be too low down so that you're out of the right area.
So you want to get the right balance between doing enough skin preparation so that you don't have to do it again, but not so much that you end up unsettling them and upsetting them so that you can't get them back to sleep again afterwards.
So there is a fine balance between doing enough scrubbing and not too much scrubbing. But hopefully, this will be okay. We'll check our impedances in a moment to see how they are.
Electrode placement
We'll just get these electrodes on. So I'm using these electrodes. I really like these ones, they're nice and sticky. But they also have a bit of conductive gel just in the middle of them. So you don't want to press on that. You want to press on the white bit around the outside. Otherwise, you can make the gel disperse out around.
Presenter
