I would have to agree that someone unfamiliar with detailed anatomy, physiology, evoked
potentials, and operating room procedures should not be performing IOM. However, a well
trained audiologist with substantive experience performing clinical EP's can obtain training
to get involved with IOM from a variety of sources. Nat'l organizations (ASHA, AAA, ASNM,
etc.) periodically offer training workshops that are a good place to start. Finding someone
that is doing IOM and spending time observing, discussing, training is also a good way to
begin the learning process. I do believe that audiologists, when appropriately trained, are
the best chioce for AEPs in the OR.
I have done IOM, and was responsible for establishing an IOM program in a major medical
campus. Prior to my involvement, the anesthesia folks were setting up and doing AEP's in
the OR--ALL WRONG! When I observed I'd casually ask the resident or MD in front of the
EP device-"Where's wave V?" or "What constitutes a significant change in the waveform?".
No one could answer any of the questions I'd pose. Further, they had modified the
transducers in such a way that their measures were invalid. The neurosurgeons and
neurotologists were happy to be getting timely and relaible feedback in the OR once we
Training is available. Look hard, ask around. Get trained and know your limits. Audiologists
can and very often do an excellent job with IOM and are a good choice.