NerveNerveääna In-Servicena In-ServiceOR NursesOR Nurses

The Big Picture

• About NerveänaAbout Nerveäna• Product OverviewProduct Overview• PreparationPreparation• The SetupThe Setup

About Nerveäna

Neurovision Medical Products• Focus – Proactive nerve location

technology

• Nerveäna – The 4th Generation Nerve Locator

• 25 year track record of success

Delivers stimulations and analyzes the responses

• Delivers milliamp pulses via Stimulating Hemostat

• Analyzes responses of nerve via (surface) electrode- Gives the surgeon feedback in audio alarm

and audio electromyograph (EMG)

- EMG waveforms can be displayed on a PC

• The Result: An intuitive surgical nerve location tool

The Way the Nerveäna Works

About Nerveäna

• Thyroidectomy - Recurrent and Superior Laryngeal Nerves

• Parathyroidectomy - Recurrent Laryngeal Nerve

• Parotidectomy - Facial Nerve (VIIth cranial)

• Otologic Surgery - Facial Nerve (VIIth cranial)

• Neck Dissection - Accessory Nerve (XIIh cranial)

The Nerveäna – For the Following Procedures and Related Nerves at Risk

About Nerveäna

• The Nerveäna system consists of the Nerveäna, disposables, and non-disposables.

• All disposables are contained in the Surgical Kit.

• There are three different Surgical Kits.

About Nerveäna

The Nerveäna

About Nerveäna

The Nerveäna EMG

About Nerveäna

Surgical Kit for Thyroidectomy and Parathyroidectomy

Surgical Kit for Facial Nerve (Parotidectomy;Otologic Surgery)

The Nerveäna Surgical KitsSurgical Kit for Accessory Nerve (Neck Dissection)

About Nerveäna

Contents of the Surgical Kit for Thyroidectomy and Parathyroidectomy

• Laryngeal Surface Electrode in a sterile pull pack

• Stimulating Hemostat lead wire and subdermal needle electrode in a sterile peel pack

• One Hydrogel surface electrode

Contents of the Surgical Kit for Facial Nerve

(Parotidectomy; Otologic Surgery)

• Stimulating Hemostat lead wire and subdermal needle electrode in a sterile peel pack

•Two paired Hydrogel surface electrodes

• One Hydrogel surface electrode

About Nerveäna

Contents of the Surgical Kit for Neck Dissection

• Stimulating Hemostat lead wire and a subdermal needle electrode in a sterile peel pack

• Three Hydrogel surface electrodes

• The two (BLACK) EMG and Stim cables

• The Stimulating Hemostat

Nerveäna Non-Disposables

About Nerveäna

Product Overview

The Nerveäna, shown with all attachments

Preparation

Have Ready in the ORHave Ready in the OR• A fully charged NerveA fully charged Nerveääna na (and power cord, if needed) (and power cord, if needed)

• The two (black) Stim and EMG cablesThe two (black) Stim and EMG cables

• The Stimulating Hemostat (sterile)The Stimulating Hemostat (sterile)

• The correct Surgical Kit for the procedureThe correct Surgical Kit for the procedure

Preparation

Prior to SetupPrior to Setup• Proceed with Setup (Steps One, Two and Three Proceed with Setup (Steps One, Two and Three

below) below) afterafter intubation and placement of Stimulator intubation and placement of Stimulator (needle) and EMG (hydrogel surface) ground (needle) and EMG (hydrogel surface) ground electrodes by the electrodes by the anesthesiologist (or surgeon)anesthesiologist (or surgeon). .

• The The scrub nursescrub nurse should have the Stimulating should have the Stimulating Hemostat and its (red) lead wire.Hemostat and its (red) lead wire.

FYI --Placement of Electrodes• The white, needle, stimulator ground

electrode is placed just subdermal (cover with surgical tape).

• Hydrogel surface electrodes are placed after ten strokes (one direction) with the triangular pad (black side) on the skin area, followed by alcohol wipe/dry (cover with surgical tape).

Setup

The Setup - OR NursesThe Setup - OR Nurses

•Step 0ne: NerveStep 0ne: Nerveääna Setupna Setup

•Step Two: Connect Electrode LeadsStep Two: Connect Electrode Leads

•Step Three: Connect StimulatingStep Three: Connect Stimulating Hemostat Red Lead Hemostat Red Lead

Setup

Step OneStep One: Nerve: Nerveäna Setup (circulator)äna Setup (circulator)• Place the Place the NerveNerveäna on battery power* on flat, äna on battery power* on flat,

stable surface such as Mayo table (not on stable surface such as Mayo table (not on other electrical devices).other electrical devices).

• Connect black “EMG” and “STIM” cables to Connect black “EMG” and “STIM” cables to ports on back of Nerveports on back of Nerveäna äna (one way only).(one way only).

(*The AC battery charger can be used but may cause some “noise.”)(*The AC battery charger can be used but may cause some “noise.”)

Setup

Step One: NerveStep One: Nerveäna (back) with Stim äna (back) with Stim and EMG Cables Connectedand EMG Cables Connected

Setup

Step TwoStep Two: Connect Electrode Leads : Connect Electrode Leads (circulator) (circulator)

• EMG cable terminalEMG cable terminal: Connect the Red and : Connect the Red and Blue electrode lead wires to Red and Blue Blue electrode lead wires to Red and Blue ports. Connect the Green electrode ground ports. Connect the Green electrode ground lead to Green port.lead to Green port.

• Stim cable terminalStim cable terminal: Connect the White : Connect the White (needle) ground electrode lead wire to White (needle) ground electrode lead wire to White port.port.

Setup

Step Two - Connect Electrode LeadsStep Two - Connect Electrode Leads

Setup

Step ThreeStep Three: Connect Dissecting Stimulator: Connect Dissecting Stimulator Lead Wire Lead Wire

• TheThe scrub nurse scrub nurse connects connects BlueBlue end of Red end of Red lead wire to (Blue) Stimulating Hemostat and lead wire to (Blue) Stimulating Hemostat and passes the Red end of lead wire off the sterile passes the Red end of lead wire off the sterile field to field to circulatorcirculator for connection to Red port for connection to Red port on Stim cable terminal. on Stim cable terminal.

(During surgery, the scrub nurse passes Stimulating Hemostat (During surgery, the scrub nurse passes Stimulating Hemostat to surgeon.)to surgeon.)

Setup

Step Three – Connect the (Red) Dissecting Step Three – Connect the (Red) Dissecting Stimulator Lead Wire Stimulator Lead Wire

Setup

The Nerveäna Setup for Thyroidectomy and Parathyroidectomy

Setup

The Nerveäna Setup for Facial Nerve (Parotidectomy and Otologic Surgery)

Setup

The Nerveäna Setup for Neck Dissection (Accessory Nerve)

Setup

Power up and verify these settings and responses:Power up and verify these settings and responses:

During the surgeryDuring the surgery, the surgeon may request the stimulation level , the surgeon may request the stimulation level to be changed (circulator adjusts the Stimulation Knob).to be changed (circulator adjusts the Stimulation Knob).

Setup

• In practice, the above Steps may vary In practice, the above Steps may vary depending on specific OR procedures and depending on specific OR procedures and preferences.preferences.

In Practice --

Setup

Complete Instructions

•Nerveäna Quick Reference (supplied)•Instruction Sheet with each Surgical Kit• www.neurovisionmedical.com

(Instructions, Support Videos)•Email, fax, or call Neurovision

Questions

Ventura, CA USA

866-815-6999

www. neurovisionmedical.com

Neurovision Medical Products