NOTE: This section only applies if you are using the *Wireless Bluetooth connected EMG scanner (neuroCORE).*
The wireless EMG scanner uses the same scanning technology as the wired scanner, but because it is designed to be used with one hand instead of two and both sensors are fixed in place (with some limited swiveling motion possible), there are a few differences in how you perform a scan.
One of the biggest differences is the touch screen display on the device. Because the device is not tethered to a base station, you have the freedom to move around your exam room with the device. You also no longer need to watch the PC screen when scanning. You can use the neuroCORE touch screen to conduct the scan and go back the PC to review and save it.
The neuroCORE touchscreen shows all the vital information you need while scanning:
The neuroCORE protocols go in the opposite direction from the wired EMG protocols. In other words; they start at S1 and go UP the spine to C1, like the Rolling Thermal protocols. This is to support unilateral scanning in the cervical regions, as explained in the next section.
You prep the patient just as you would for the wired EMG. After you click Start Scan, the protocol will prompt you for the first site, S1 in the standard protocol. Place the device on the patient’s back in the correct position for that vertebra. Notice that the heads of the device swivel independently, allowing you to make sure that all three metal tips are making good contact with the skin.
Now look at the device screen, as pictured above. In the center of the screen you will see the current location indicated. Just above that is a real-time graph indicating the data streaming in from the sensors. At the very bottom are two colored blocks which are red initially. Once the signal from the device becomes stable, they will both turn green. Each block corresponds to a sensor, left and right. When both blocks are green, you can press the trigger to take a reading.
The display will then change slightly, to show the values you just took for a brief time before moving to the next site. If you don’t like the reading and need to re-scan, you can touch the site location on the device’s touchscreen to move the protocol back to the previous site, as described above.
Because the neuroCORE scanner heads are attached, it can be difficult for both sides to make good contact at the same time in the cervical region. This is the same effect seen with the Thermal Scanner at C1 – you cannot measure both sides at once instead you measure first the left side then the right.
You will need to do the same thing with the neuroCORE scanner. At some point, most likely in the cervical region, you will go from scanning both left and right sides together to first scanning the left, then the right. We call this unilateral mode because you are scanning one side at a time.
Since the unilateral sites are usually all going to be in the cervical region, we have changed the direction of the standard EMG scan to start at S1 and continue up the spine through C1, just like the Rolling Thermal scan. When you reach C7, you will be prompted for first left, then right. You will be prompted both via voice prompt and also by an on screen arrow which indicates that we are scanning left, then right.
For most patients, you will need to start scanning unilaterally at C7. For some, however, you might be able to scan bilaterally until you get higher into the cervicals, C5 or even C3. Others, you might need to start lower. For this reason, you can adjust the site at which you start scanning unilaterally by selecting a different site from the drop down list on the page.
You can even choose to not scan unilaterally at all by selecting None from the list. For the clear majority of patients, however, you will want to scan unilaterally in the cervical region, which is why the default value of this selection is C7.
There are a few settings you can modify to change the behavior of your neuroCORE device. To see these, go to the Settings Form from the Task Pad and select EMG Scan:
The two neuroCORE settings are:
neuroCORE Scan Delay: This is the brief delay after you pull the trigger before the neuroCORE protocol moves on to the next site. The purpose of this delay is to allow the user time to see the values on the device’s touchscreen. You can adjust it to .25 secs, .5 secs, 1 second (default) or 2 seconds.
Stable window: Sometimes, the act of pulling the trigger can introduce some noise into the signal (what we call signal jiggle because the device itself moves a bit). If this is a problem, you can increase the stable window, which defaults to 1, to a greater value up to 5. This adjusts the point in time at which we select the desired value from the stream of data, so that we are selecting a value from just prior to the trigger pull.
Do not adjust this value unless you believe you are experiencing this issue.