Users Manual Part 1

5
Nerve Integrity Monitor
9. Press , or the MONITORING tab to begin monitoring on the Monitoring screen. The NIM Vital system is ready to monitor with
its default settings.
10. After the patient is draped, connect a sterile NIM monopolar stimulator probe to the STIM 1 jack (color-coded black plug and
black socket).
The basics of what you will see and hear during monitoring
The following procedure is meant to be completed by surgeons and OR sta users. Refer to the “MONITORING tab” topic for more
information.
1. The surgeon uses the stimulator probe as the primary means to conrm the location and integrity of the nerves. Refer to warning
W3.
One of two events may occur:
• The NIM system sounds a “Current Delivery” tone (a short tweedle sound) when contacting tissue, but not evoking a response.
The tone indicates the set current is being delivered.
• Upon stimulation of the nerve, EMG is evoked, and the default audible tone is heard at ~4X/sec and raw EMG (thump, thump,
thump). The EMG event is also shown on the monitoring screen as a waveform (gure 1).
Figure 1. Biphasic EMG waveform showing peak-to-peak measurement or amplitude
Note: the latency is measured from the stimulus from the left-hand side of the screen to the start of the EMG waveform.
2. Between probe uses the NIM is passively monitoring muscles and you may hear changes in the EMG, or mechanically evoked
nerve responses that look and sound similar to stimulator evoked nerve responses. Note: The NIM may not alert the surgeon to
all types of surgical manipulation of the nerve including sharp, surgical resection.
3. The surgeon conrms the integrity of the nerve using the probe throughout the entire procedure and at the end of the
procedure. Refer to the table of contents “Audio - understanding what you hear” topic for more information.
Unboxing and installing the system
Check o the contents of the box against the packing slip. If incomplete or damaged, notify customer service at [phone].
If the container is damaged or cushioning material shows stress, notify the carrier and customer service. Keep the shipping materials
for carrier inspection.
After unpacking, save the cartons and packing material. If the NIM Vital system is to be shipped, the shipping package will provide
proper protection.
FCC use only, not for Medical use