Neurophysiologist Trauma Neurosurgery & Critical Care

Neurophysiologist Trauma Neurosurgery & Critical Care (Job ID: 9078)

Duties and Responsibilities:

• Perform intra-operative neuromonitoring on patients undergoing surgery that puts the nervous system at risk.
• Set up and perform accurate and interpretable intraoperative monitoring studies (SEP, MEP, BAER, EEG, EMG)
• Troubleshoot technical issues, and ensure equipment is functioning in an effective and efficient manner
• Prepare electrodes and stimulators prior to surgery in accordance with the hospitals infection prevention and control practices
• Prepare written electronic reports documenting all procedures, including tests performed results, and any other relevant data, in accordance with hospital, departmental and research policies and procedures.
• Participate in neuroscience research.
• Prepares lecture materials and instruct students, residents, and colleagues on specific topics within the ION field.
• Perform Neuromonitoring testing for trauma & Neurosurgical patients in the TNICU (for traumatic brain injury, spinal cord injury and nerve injury) and anoxic brain injured patients.
• Perform all patient care responsibilities with a clear understanding of the adherence to hospital and departmental policies and procedures and with a commitment to contributing to the hospital vision, mission and values.
• Consult with surgeon about patient¿s IONM needs. Recommend appropriate IONM methods and explain usefulness and limitations of selected IONM protocol to surgeon. Propose the most appropriate anesthesia regime for IONM to anesthesiologist and explain rationale.
• Perform multiple assessments and measurements to ensure the pathways at risk during surgery are not being compromised and/or neural structures are identified and protected.
• To evaluate the stimulus and recording parameters so that neurophysiological recordings are robust and table throughout surgery.
• Interpret the IONM results and relay changes immediately to surgeon. Consult with anesthesiology to ensure systemic factors are optional for neurological function. Rule out technical pitfalls and artifacts.
• To interpret IONM results so that appropriate crisis management is promptly initiated when indicated. This includes ¿troubleshooting¿ to ensure that the critical deterioration of IONM recordings related to surgical insult are not confounded by changes caused by technical artifacts and pitfalls, or a change in anesthesia.
• To verbalize changes in recordings to the surgeon ¿on-the ¿spot¿ so corrective measures may be taken to prevent major neurological or surgical catastrophic (e.g. brain injury, paralysis or death).
• Contribute to solutions leading to surgical decisions by communicating any changes in recordings to the surgeon to ensure any necessary corrective measures can be taken to prevent major neurological or surgical catastrophes (e.g. brain injury, paralysis or death).
• Document patient history, monitoring protocols, electrode combinations, muscles monitored, systemic factors, type and depth of anesthesia, surgical events, neurophysiological events and summary of finding in the IONM Log and update patient chart by documenting and recording patient history in the IONM log/chart.
• Assess and select the correct technique modality for monitoring patients to ensure the specific pathways at risk are identified and protected from surgical insult.
• Assess the patient¿s physiological status during surgery by monitoring vital signs, anesthesiology gases and drugs.
• Collaborate with anesthesiologist before and during surgery to ensure anesthesia and vital signs meet the requirements necessary for stable neurophysiological monitoring.
• Participate in complex care plans that ensure continuous IONM during physical routines/interventions
• Testing trauma & Neurosurgical patients in the TNICU (for traumatic brain injury, spinal cord injury and nerve injury) and anoxic brain injured patients. Select appropriate test(s), perform tests, interpret results and grading systems for predication of outcomes
• Consult with TNICU staff about patient¿s physiological testing needs. Explain usefulness and limitations of the selected protocol to staff. ¿Troubleshoot¿ to ensure that the test results are not confounded by changes caused by artifacts or pitfalls, related to medications, pre-morbid conditions etc. Suggest the most appropriate action to ensure high quality recordings to medical staff (e.g. the use of short acting neuromuscular blockade to reduce muscle artifacts) and explain rational. Optimize the stimulus and recording parameters so that physiological recordings are robust and stable.
• Document the patient history, neurological findings, systemic factors, radiological findings and surgical procedures on the Physiological testing form
• Collaborate other members of the multi-disciplinary team ( e.g. TNICU nurses, intensivists and surgeons, to improve patient care.

Qualifications:

• Must have a Bachelor of Health Science, Biological Science (i.e. Kinesiology). Degree in Health Science, Biological Science preferred
• Must have a Professional Membership with the Canadian Association of Neurophysiological Monitoring.
• Intraoperative Neurophysiological Monitoring Graduate Certification required
• Minimum one year of intra-operative neuromonitoring experience in a large Canadian tertiary care centre required
• Thorough understanding of anatomy and neurophysiology
• Proven communication and problem-solving skills
• Good interpersonal skills
• Ability to work under stressful conditions and maintain focus and concentration within the operating room environment