Difference between revisions of "Policies and Procedures"

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These documents comprise the official policies and procedures for the MEG lab.  
 
These documents comprise the official policies and procedures for the MEG lab.  
 
*<big>MEG Core Facility</big>
 
  
 
<div style="text-align:center;"></div>
 
<div style="text-align:center;"></div>
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===<big>'''Operations(1.00)'''</big>===
+
===<big>'''Operations'''</big>===
  
==== '''Hours of Operation 1.00''' ====
+
==== '''Hours of Operation''' ====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
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|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Revised 9/03; 6/06; 7/07; 10/08; 8/09; 1/12; 1/14; 1/15'''
+
'''Revised 9/03; 6/06; 7/07; 10/08; 8/09; 1/12; 1/14; 1/15; 8/18'''
 
<br>
 
<br>
 
<br>
 
<br>
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<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The MEG Core Facility hours of operation are from 9:00 a.m. to 5:00 p.m. Monday thru Friday.'''</div>
 
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The MEG Core Facility hours of operation are from 9:00 a.m. to 5:00 p.m. Monday thru Friday.'''</div>
 
<br>
 
<br>
::1) Normal hours''' '''of operations''' '''9:00-5:00 pm Monday - Friday. The MEG Core Facility staff will be available to assist users during normal hours of operation.
+
::1) Normal hours''' '''of operations''' '''9:00-5:00 pm Monday - Friday. The MEG Core Facility staff will be available to assist users during normal hours of operation. The MEG Core Facility staff MAY be able to assist users outside these hours, at their discretion, with prior authorization and notice of at least one week; please see the MEG Core staff Request Form (under construction).  
  
::2) Users may schedule scans for after hours provided they have received training and are capable of operating MEG equipment in accordance with MEG policies and procedures. <br>After hours use authorization must be obtained from MEG Core staff.
+
::2) Users may schedule scans for after hours provided they are certified as an authorized independent user, and conduct studies in accordance with MEG policies and procedures. Please see [[Policies and Procedures#User and Safety Guidelines|User Guidelines]] for further information.
  
  
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<br>
 
<br>
  
==== '''Laboratory Access 1.05''' ====
+
==== '''Laboratory Access ''' ====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
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|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Revised 9/03; 6/06; 7/07; 10/08; 1/12; 1/14; 1/15; 2/18'''
+
'''Revised 9/03; 6/06; 7/07; 10/08; 1/12; 1/14; 1/15; 2/18; 8/18'''
 
<br>
 
<br>
 
<br>
 
<br>
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::3) '''''After Normal Hours of Operations''''' and on the weekends- the MEG Lab will be locked, however, access can be gained by using the keyless entry system.  
 
::3) '''''After Normal Hours of Operations''''' and on the weekends- the MEG Lab will be locked, however, access can be gained by using the keyless entry system.  
  
::4) All equipment, except for all computers (acquisition and workstation), must be powered off upon departure.
+
::4) All equipment, except for all computers (acquisition and workstation) and electronics, must be powered off upon departure.
  
 
::5) It will be the responsibility of the user to make sure the lab is locked upon departure.
 
::5) It will be the responsibility of the user to make sure the lab is locked upon departure.
  
 +
::6) After hours access to the NMR Center, which houses the MEG Lab, is given at the discretion of the NMR Center staff.
  
<div align="center">_________________________________________________________________________________________________ </div>
+
<br><div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div><br>
 
 
<br><div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 
  
===<big>'''Scheduling (2.00)'''</big>===
+
===<big>'''User and Safety Guidelines'''</big>===
  
==== '''Scheduling 2.00''' ====
+
==== '''Policy governing user requirements and laboratory safety''' ====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
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'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Scheduling Procedures'''<br>
+
'''User Guidelines'''<br>
'''Policy No. 2.00'''
+
'''Policy No. 3.00'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Revised 9/03; 6/06; 7/07; 10/08; 1/12; 1/14; 1/15; 2/18'''<br>
+
'''Reviewed: 6/03; 9/03; 6/06; 7/07; 10/08; 1/12; 1/14; 1/15; Revised: 2/18; 8/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
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|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: MEG scan time will be requested and scheduled electronically via the web-based calendar at: http://kurage.nimh.nih.gov/cal/.'''  Scan time will be scheduled on a first-come -first served basis.  All requests must be approved before going "live" on the public calendar.  All unapproved time requests will appear in red. When a MEG schedule notification is received, an MEG administrator will be responsible for approving or denying the request. Users will auto matically receive an email message notifying them when their time has been approved.
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: All investigators interested in conducting MEG scans / research studies are required to meet all the requirements of the Institutional Review Board (IRB) and adhere to all MEG Core Facility policies and procedures as outlined below.
 +
 
 
<br>
 
<br>
 
 
'''Procedure:'''
 
'''Procedure:'''
:I. '''Requesting Time - '''
 
  
::1. Click on Login location near the bottom of the MEG Schedule/Calendar.
+
::'''I. <u>Becoming a User: Training and Authorization</u>'''
::2. Enter “Username” and “Password”.
 
::3. Click on Login.
 
::4. On the calendar - Click on the  at the day and time desired.
 
::5. Enter the “Add Entry” form information –
 
  
::::a. '''Investigator’s Name''' - enter the last name of the PI / last name of the person who is going to run the scan (acquisition computer). For example - BERMAN / J. Mitchell. In this case Dr. Berman is the PI and Judy Mitchell is running the scan.
+
::::'''1. MEG Orientation'''
::::b. '''Description of experiment''' – provide a simple description
+
::::::a. Users must schedule / attend an official MEG orientation to become familiar with the lab operations and equipment. '''Any personnel present in the MEG laboratory during acquisition must complete the MEG orientation, including all clinical support staff.'''
::::c. '''Comments''' - Use this field to enter any private comments, subject name / phone number or MIS number. '''''Information in this box will not appear on the published calendar.'''''  '''''Important: ::::This box is for confidential information.'''''
 
::::d. '''Sensor position''' – Sitting or Supine.
 
::::e. '''EEG electrodes''' – indicate whether EEG, EOG, EMG electrodes will be used.
 
::::f. '''Date'''
 
::::g. '''Time''' - military time.
 
::::h. '''Duration''' – indicate how much time needed to complete your study. Please allow enough time for any possible delays (set up / prep time, subject late, equipment malfunction, etc.).
 
::::i. '''Hold approval''' – only use holds if your subject needs to get back with you to confirm the appointment. Appointments can only be held for 2-3 days.
 
::::j. '''Participants''' – '''DO NOT ALTER THIS FIELD''' (should always be admin for MEG staff who are doing the scheduling).
 
::::k. '''Repeat Type''' – if a recurring appointment enter here; however, check with Staff Scientist before scheduling any repeats!
 
::::l. '''Repeat End Date''' –  *for recurring appointments only.
 
::::m. '''Repeat Day (weekly''') - *for recurring appointments only.
 
::::n. '''Frequency''' –  for recurring appointments only.
 
  
::6. Click on “Save”.
+
::::'''2. Authorized Independent User Requirements'''
 +
::::At least one of the persons in attendance at every MEG session must be authorized to operate the MEG independently. The authorization process involves several steps. To become authorized, the user is expected to become competent in performing all aspects of MEGs. MEG Core staff is available to provide training and technical assistance. Steps to becoming an authorized independent user appear below.
  
 +
::::::a. The first step in becoming an authorized independent user is to attend the MEG Orientation.
 +
::::::b. Following completion of the orientation, each new user must assist with a minimum of two (2) MEG sessions, and independently perform one additional MEG session, in the presence of MEG Core facility staff or an authorized trainer. Additional observed sessions may be required to achieve competency. To request MEG Core Staff assistance/training use the MEG Core Staff Request Form (Under construction).
 +
::::::c. Scientific staff in NIMH IRP labs at the doctoral level with at least one full year of experience as an independent user may be named as an authorized trainer at the discretion of the MEG core facility.
 +
::::::d. Post-baccalaureate IRTA trainees can become authorized independent users, although they may not serve as authorized trainers.
 +
::::::e. New users who have performed all procedures in the presence of MEG Core staff (or an authorized trainer) and have attained competency in all skills will be added to the authorized independent user list. The authorized independent user list and the authorized trainer list will be maintained by the lab manager and technologist, Judy Mitchell.
  
:II. '''To Edit or Cancel an Appointment – '''
+
::'''II. <u>Initiating a MEG Study</u>'''
::::a. Click on the login.
+
::::'''1. Study Design Review and Approval'''
::::b. Enter User Name and Password.
 
::::c. Click on the entry to be changed (at the point where it gives the little popup detail description).
 
::::d. Click on option: Edit entry, Delete entry, Add to My Calendar, etc.
 
  
*Please note: you must be the owner to be able to edit or delete an entry in the schedule.
+
::::::a. Users must provide the director and/or staff scientist with a description of the research study design including information regarding setup requirements, software, and equipment needs.
  
:III. '''To Refresh the Calendar – '''
+
::::'''1. Protocol Approval'''  
::1. Click on My Calendar.
+
::::::a. User groups are required to have an IRB approved protocol with a description of the intended MEG research before any human subjects can be scanned.  
  
 +
::::::b. Established users with new protocols will be required to complete a “new” Facility Access Request for each new protocol indicating the new protocol number; see [[Policies and Procedures#Facility Access Requests|Facility Access Requests]] and [[Policies and Procedures#Scheduling|Scheduling]] below.
  
 +
::::'''4. Routine Studies'''
  
<div align="center">_________________________________________________________________________________________________ </div>
+
::::::a. The MEG core facility requires that at least two persons are present '''in the room''' at every MEG session. Both persons must have completed the MEG orientation. One person must be monitoring the subject inside the MSR at all times. One person may be clinical support staff. One person may be MEG Core facility staff, with prior approval and notice of at least one week. Please use the MEG Core Staff Request Form (Under construction)
<br>
+
::::::b. One of the two persons present at every MEG session must be authorized to operate the MEG independently (or must be MEG core facility staff). The next session details the authorization procedure.
 +
::::::c. Any invasive studies (i.e. studies involving infusions, blood draws, etc.) must be accompanied by personnel with NIH CC clinical credentials. This person must have completed the MEG orientation, and can also serve as the second person.
 +
::::::d. Upon review of the IRB approved protocol for non-invasive studies involving research subjects who are not classified as healthy volunteers, the MEG core facility may require NIH CC credentialed staff to be present during recordings.
 +
::::::e. '''One person must be monitoring the subject in the MSR at all times.'''
  
==== '''Facility Access Requests 2.01''' ====
+
::::'''2. Equipment Testing / Task Setup'''  
'''National Institute of Mental Health'''
+
 
{| class="wikitable"
+
::::::a. The MEG Core facility recommends initial pilot testing of task paradigm, equipment, software, etc. without a research subject.  
|style="width: 350px"|
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''Facility Access Requests'''<br>
 
'''Policy No. 2.01'''
 
|style="width: 650px"|
 
'''Date: 3/03 <br>
 
'''Revised 9/03; 6/06; 7/07; 10/08; 1/12; 1/14; 1/15; 2/18'''<br>
 
<br>
 
|-
 
|
 
'''Recommended By:'''<br>
 
'''MEG Core Facility Staff'''<br>
 
|
 
'''Distribution: MEG Core Facility'''
 
|-
 
|}
 
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: Each MEG user who wants to schedule subjects for an MEG scan must filled out and electronically submit the MEG Facility Access Request Form (FAF). The Facility Access user account will allow the MEG user to: 1) schedule MEG scans via the MEG Lab scheduling calendar and, 2) access MEG data. The MEG Core Facility website administrator will be responsible for approving and maintaining all facility access requests.  
 
<br>
 
  
 +
::::::b. MEG Core staff are available, upon request, to assist in troubleshooting during pilot testing, with at least one week's notice. Please indicate the need for any special training, i.e., training or assistance with EEG/EP electrode placement or setup on the MEG Core Staff Request Form (Under construction)
  
Procedure:
+
::::::c. Users must schedule time via the web calendar for all testing.  When scheduling indicate in the scheduling module that the appointment is for "pilot testing: no subject". 
  
::::1. A Facility Access Request (FAF) must be submitted electronically to become a MEG Lab user.  The form may be accessed via the MEG Lab website at: http://kurage.nimh.nih.gov/meglab  under User Information  Becoming a User.
+
::::'''3. Pilot Studies'''
  
::::2. All the requested information must be provided, such as the protocol #, PI’s last name and the name of the person who be in the MEG Lab running the study. In addition, we must have a cell phone number so that we can contact you in an "emergency".
+
::::::a. The MEG Core facility recommends a pilot study to test equipment, paradigms / programs and refine procedures with a test subject. Users must provide their own volunteer subject; if this is an external volunteer, he/she must be consented according to IRB guidelines.  
  
::::3. The username will be the user’s last name as entered on the Facility Access Form (FAF).  
+
::::::b. MEG Core staff are available, upon request, to assist during pilot testing, with at least one week's notice. Please indicate the need for any special support. Please use the MEG Core Staff Request Form (Under construction).
  
::::4. When a Facility Access Request Form is received the accounts administrator will assign an account and issue a temporary password.
+
::::::c. You must schedule time for the pilot study via the web calendar.  Please indicate in the description that time is being requested for a “pilot study”.
  
::::5. An email notification of the account name and temporary password will be sent to each applicant.
+
::::::d. Pilot studies with a subject are required to have two persons in attendance who have completed the MEG orientation (in addition to the subject). One person may be MEG Core facility staff.
  
::::6. User accounts may not be shared.
+
::'''III. <u>User Log</u>''' 
 +
::Users MUST document any scan that they perform in the User Log Book. If a subject was set up for the MEG but the scan was not performed – that scan must still be logged in the User Log Book with a comment explaining why the study was not performed.  
  
 +
::Subject information and all other pertinent information must be filled out in the log book, i.e., date, PI name, operator’s initials, protocol #, subject’s initials, MRN, and the gantry position. Do not leave any blank entries.
  
 +
::'''IV. <u>Lab Safety</u>'''
 +
::::'''1. Equipment Operation''' - When performing a MEG study there must be at least two persons assisting with a study; one person must be an authorized independent user and both persons must have completed the MEG orientation. 
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
+
::::'''2. Subject Safety''' – a subject must never be left alone in the MSR without an investigator in the control room for any reason.  <u>The subject must be observed by an investigator at all times</u>. Violation of this procedure may lead to revocation of lab access priveleges.
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 
<br>
 
  
===<big>'''User / Subject Guidelines (3.00)'''</big>===
+
::::'''3. Chair / Table Safety''' – Care should be taken when raising the chair / table when you have a subject sitting or supine in the gantry. Operating instructions are below in [[Policies and Procedures#Chair Operation|Chair Operation]]. The chair has a 300 lbs. maximum weight limit, and the bed (for supine recording) has a weight limit of 250 lbs.
 +
 +
::::'''4. Gantry Safety''' – Never adjust the gantry (tilt or angle) when a subject is seated in the chair or lying on the table.  Instructions are available in [[Policies and Procedures#Gantry Operation|Gantry Operation]].
 +
::::5. If a medical emergency occurs call 111.  For Fire or Police call 911. For any other emergency contact the director or staff scientist for assistance at the phone numbers posted in the lab. 
  
==== '''User Guidelines 3.00''' ====
+
::'''V. <u>User Feedback and Problem Reporting</u>'''
'''National Institute of Mental Health'''
+
::::'''1. User Feedback''' – Users are encouraged to make suggestions and provide feedback to MEG staff, by directly contacting the staff scientist (Tom Holroyd) and director (Allison Nugent). 
{| class="wikitable"
+
::::'''2. Problem Reporting''' – Users are responsible for reporting complications, incidents, or problems that occur involving the facility via the Problem Report Form (under construction). Any variance/problem occurring that affected subject safety should be reported immediately to the institute clinical director and the IRB by the investigators in addition the the MEG Core director; reporting of unanticipated problems or adverse events to the IRB is not the responsibility of the MEG Core facility.
|style="width: 350px"|
+
::::'''3. Equipment Failure''' -Users are also responsible for reporting any equipment failure or any equipment that may not be working properly via the Problem Report Form (under construction). Any equipment that is inoperable or broken should be labeled as such, and the staff scientist (Tom Holroyd), Director (Allison Nugent) and Lab Technologist (Judy Mitchell) should be informed immediately.
'''Subject:'''<br>
+
 +
::'''VI. <u>Magnetically Shielded Room (MSR) Guidelines</u>'''
 +
::There are no known risks associated with MEG/EEG recordings. Although wearing metal objects while in the MSR (Magnetically Shielded Room) is not harmful to the individual, bringing metal objects in the MSR can result in a poor quality / uninterruptible recording.  In addition, bringing magnetized objects into the MSR can cause trapped flux in the SQUIDS which can lead to long and expensive service to fix causing obvious interruptions and scheduling delays.  Thus, we have established these guidelines:
 +
 
 +
::::1. Subjects should not bring any metal objects inside the MSR.  Any subject entering the MSR must first “de-metal” (remove any metal objects; empty pockets; remove jewelry, hairclips, pens, clipboards etc.). These include belts, keys, watches, rings/earrings, necklaces, coins, eyeglasses and pieces of clothing with metal parts such as bras with underwires or bras with metal adjustment rings. Non-metallic subject clothing is available in the laboratory upon request.
 +
 
 +
::::2. No one (not subjects / nor MEG Users) should bring electrical equipment inside the MSR.  Objects such as cell phones, pagers, cameras, flashlights, or any other electrical equipment are strictly forbidden.   
 +
 
 +
::::3. Magnets and anything magnetized is never allowed inside the MSR.
 +
 
 +
::::4. No one should wear shoes inside the MSR.  To prevent any metal or magnetic dust from getting into the MSR shoes must be removed before entering the MSR, or shoe covers (provided) should be used.
 +
 
 +
::::5. Any “unapproved” equipment should not be brought into the MSR.  Any “special” equipment must be approved by the director or staff scientist prior to its use.
 +
 
 +
::::6. Do not use small metal objects (i.e., staples, paper clips) around the MSR.
 +
 
 +
::::7. NO equipment will be left in the MSR other than the equipment that belongs in the MSR. 
 +
 
 +
<div align="center">_________________________________________________________________________________________________ </div>
 +
<br>
 +
 
 +
===<big>'''Scheduling'''</big>===
 +
 
 +
==== '''Scheduling''' ====
 +
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''User Guidelines'''<br>
+
'''Scheduling Procedures'''<br>
'''Policy No. 3.00'''
+
'''Policy No. 2.00'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 6/03; 9/03; 6/06; 7/07; 10/08; 1/12; 1/14; 1/15; Revised: 2/18'''<br>
+
'''Revised 9/03; 6/06; 7/07; 10/08; 1/12; 1/14; 1/15; 2/18; 8/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
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|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: All investigators interested in conducting MEG scans / research studies are required to meet all the requirements of the Institutional Review Board (IRB) and adhere to MEG Core Facility policies and procedures as outlined below.
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: MEG scan time will be requested and scheduled electronically via the web-based calendar at: http://kurage.nimh.nih.gov/cal/.'''  Scan time will be scheduled on a first-come first-served basis.  All requests must be approved before going "live" on the public calendar.  All unapproved time requests will appear in red. When a MEG schedule notification is received, an MEG administrator will be responsible for approving or denying the request. Users will automatically receive an email message notifying them when their time has been approved.
 +
<br>
  
<br>
 
 
'''Procedure:'''
 
'''Procedure:'''
::'''I. <u>Becoming a User</u>'''
+
:I. '''Requesting Time - '''
::::'''1. Protocol Approval'''
 
::::::a. User groups are required to have an IRB approved protocol with a description of the intended MEG research before a user account ID or scanning time can be assigned.
 
  
 +
::1. Click on Login location near the bottom of the MEG Schedule/Calendar.
 +
::2. Enter “Username” and “Password”.
 +
::3. Click on Login.
 +
::4. On the calendar - Click on the  at the day and time desired.
 +
::5. Enter the “Add Entry” form information –
  
::::'''2. User Accounts'''
+
::::a. '''Investigator’s Name''' - enter the last name of the PI / last name of the person who is going to run the scan (acquisition computer). For example - BERMAN / J. Mitchell. In this case Dr. Berman is the PI and Judy Mitchell is running the scan.
::::::a. A Facility Access Request must be filled out electronically (http://kurage.nimh.nih.gov/meglab ) to establish a user account.  Filling out this request will initiate the process of establishing a user account ID and password.
+
::::b. '''Description of experiment''' – provide a simple description
 
+
::::c. '''Comments''' - Use this field to enter any private comments to the MEG Core staff. These notes will not appear in the calendar. DO NOT enter personally identifying information (PII) into the calendar.
::::::b. The account ID and password will give users access to the scheduling calendar and provide access to the MEG Core Facility data storage system.  All requests must be sent electronically.
+
::::d. '''Sensor position''' – Sitting or Supine.
 
+
::::e. '''EEG electrodes''' – indicate whether EEG, EOG, EMG electrodes will be used.
::::::d. The account ID information will be emailed to the email address provided in the Facility Access Request Form, generally within 24 hours, if not call the Staff Engineer at 301/402-2362.
+
::::f. '''Date'''
 
+
::::g. '''Time''' - military time.
 
+
::::h. '''Duration''' – indicate how much time needed to complete your study. Please allow enough time for any possible delays (set up / prep time, subject late, equipment malfunction, etc.).
::::'''3. MEG Orientation'''
+
::::i. '''Hold approval''' – only use holds if your subject needs to get back with you to confirm the appointment. Appointments can only be held for 2-3 days.
::::::a. Users must schedule / attend an informal MEG orientation to become familiar with the lab operations and equipment.
+
::::j. '''Participants''' – '''DO NOT ALTER THIS FIELD''' (should always be admin for MEG staff who are doing the scheduling).
 +
::::k. '''Repeat Type''' – if a recurring appointment enter here; however, check with Staff Scientist before scheduling any repeats!
 +
::::l. '''Repeat End Date''' –  *for recurring appointments only.
 +
::::m. '''Repeat Day (weekly''') - *for recurring appointments only.
 +
::::n. '''Frequency''' –  for recurring appointments only.
  
::::::b. Established users with new protocols will be required to complete a “new” Facility Access Request for each new protocol indicating the new protocol number.
+
::6. Click on “Save”.
  
  
::'''II. <u>Initiating a MEG Study</u>'''
+
:II. '''To Edit or Cancel an Appointment – '''
::::'''1. Study Design Review'''
+
::::a. Click on the login.
::::::a. Users must provide the director and/or staff scientist with a description of the research study design including information regarding setup requirements, software and equipment needs.
+
::::b. Enter User Name and Password.
 +
::::c. Click on the entry to be changed (at the point where it gives the little popup detail description).
 +
::::d. Click on option: Edit entry, Delete entry, Add to My Calendar, etc.
  
::::'''2. System Testing / Task Setup'''
+
*Please note: you must be the owner to be able to edit or delete an entry in the schedule.
::::::a. Users must schedule a time to test their task / paradigm, equipment, software, etc.  When scheduling indicate in the scheduling module that the appointment is for a “system test”.
 
  
::::::b. Indicate whether programming or scripting support will be needed for the stimulus program.  
+
:III. '''To Refresh the Calendar – '''
 +
::1. Click on My Calendar.
  
::::::c. Also, indicate whether technical support is needed – i.e., training or assistance with EEG/EP electrode placement or setup.  If you have a specific electrode setup or placement and require MEG Core staff assistance you must provide a detailed description of your setup.
 
  
::::'''3. Pilot Studies'''
 
::::::a. Most protocols will require a pilot study to test equipment, paradigms / programs and refine procedures with a test subject. Users must provide their own volunteer subject; if this is an external volunteer, he/she must be consented according to IRB guidelines. 
 
  
::::::b. You must schedule time for the pilot study via the web calendar.  Please indicate in the description that time is being requested for a “pilot study”.
+
<div align="center">_________________________________________________________________________________________________ </div>
 +
<br>
  
 +
==== '''Facility Access Requests''' ====
 +
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Facility Access Requests'''<br>
 +
'''Policy No. 2.01'''
 +
|style="width: 650px"|
 +
'''Date: 3/03 <br>
 +
'''Revised 9/03; 6/06; 7/07; 10/08; 1/12; 1/14; 1/15; 2/18; 8/18'''<br>
 +
<br>
 +
|-
 +
|
 +
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility'''
 +
|-
 +
|}
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: Each MEG user who wants to schedule subjects for an MEG scan must filled out and electronically submit the MEG Facility Access Request Form (FAF). The Facility Access user account will allow the MEG user to: 1) schedule MEG scans via the MEG Lab scheduling calendar and, 2) access MEG data. The MEG Core Facility website administrator will be responsible for approving and maintaining all facility access requests.
 +
<br>
  
::::'''4. User Training'''
 
::::::a. There is a three-step training program specifically designed so that users can acquire practical experience. The user is expected to become competent in performing all aspects of MEGs on their own subjects.  MEG Core staff is available to provide training and technical assistance.
 
::::::::1. Instruction – (without a subject) MEG setup instructions and equipment operation.
 
::::::::2. Observation – (with a subject) instructions and observation of MEG setup and scan.
 
::::::::3. Practicum – hands on training session running a subject during a MEG scan.
 
 
::::::b. User training must be scheduled via the web-based calendar.  You must indicate in the description that this is MEG Training – Instruction, MEG Training-Observation, or MEG Training-Practicum.  MEG staff will assist users during all phases of this training.
 
 
 
::::'''5. Scheduling Scan Time'''
 
::::::a. Scan time must be requested electronically via the web-based calendar at http://kurage.nimh.nih.gov/cal/.  Currently scan time is scheduled on a first-come-first-served basis.
 
 
::::::b. To Request Time – Enter User Name and Password; click on Login; enter form information; save.
 
 
::::::c. Approvals - All requests must be approved before they will go “live” on the public calendar.  You will receive an email message notifying you that your time has been approved. All unapproved requests will appear in red.
 
 
::::::d. To Edit or Cancel an Appointment –
 
::::::::• Enter User Name and Password; click on Login;
 
::::::::• Click on the entry to be changed (at the point where it gives the little popup detail description);
 
::::::::• Select an option: Edit entry, Delete entry, Add to My Calendar, etc.
 
::::::::• *Please note: you must be the owner to be able to edit or delete an entry in the schedule.
 
 
::::::e. To Update Calendar - click on My Calendar.
 
 
::::::f. Certain times in the schedule will be reserved for maintenance / quality assurance.
 
 
::::::g. Allow about 2 hrs per subject for MEG (depending upon the study) and about 3 hrs for a MEG with EEG.
 
  
 +
Procedure:
  
 +
::::1. A Facility Access Request (FAF) must be submitted electronically to become a MEG Lab user.  The form may be accessed via the MEG Lab website [https://kurage.nimh.nih.gov/nih/faf/form.html here].
  
::'''III. <u>User Log</u>''' 
+
::::2. All the requested information must be provided, such as the protocol #, PI’s last name and the name of the person who be in the MEG Lab running the study. In addition, we must have a cell phone number so that we can contact you in an "emergency".
::Users MUST document any scan that they perform in the User Log Book.  If a subject was set up for the MEG but the scan was not able to be performed – that scan must still be logged in the User Log Book with a comment explaining why the study was not performed.  
 
  
::Subject information and all other pertinent information must be filled out in the log book, i.e., date, PI name, operator’s initials, protocol #, subject’s initials, MIS -#, and the gantry position. Do not leave any blank entries.
+
::::3. The username will be the user’s last name as entered on the Facility Access Form (FAF).  
  
 +
::::4. When a Facility Access Request Form is received the accounts administrator will assign an account and issue a temporary password. 
  
 +
::::5. An email notification of the account name and temporary password will be sent to each applicant. 
  
::'''IV. <u>Lab Safety</u>'''
+
::::6. User accounts may not be shared.
::::'''1. Equipment Operation''' - When performing a MEG study there must be at least two persons assisting with a study; one person must be capable of operating the equipment.
 
  
::::'''2. Subject Safety''' – a subject must never be left in the MSR.  The subject must be observed at all times and must never be left alone in the MSR for any reason.  Two persons must be available for assistance if the subject were suddenly to take ill or if something unexpected were to happen.
 
  
::::'''3. Chair / Table Safety''' – Care should be taken when raising the chair / table when you have a subject sitting or supine in the gantry.  In order to avoid injury, it is important to understand how to operate the chair and table.  Operating instructions are in the MEG Policy & Procedures Manual and the CTF Users Manual.  The chair has a 300 lbs. maximum weight limit and if using the bed the weight limit is around 250 lbs. maximum.
+
<br>
+
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
::::'''4. Gantry Safety''' – It is important to understand how to operate the gantry. Never adjust the gantry (tilt or angle) when a subject is seated in the chair or lying on the table.  Instructions are available in the MEG Policy & Procedures Manual and the CTF User’s Manual.
+
<br>
::::5. If a medical emergency occurs call X111.  For Fire or Police call 9111. For any other emergency contact the director or staff scientist for assistance at the phone numbers posted in the lab. 
 
  
 +
==== '''Subject Guidelines''' ====
 +
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Subject Guidelines'''<br>
 +
'''Policy No. 3.20'''
 +
|style="width: 650px"|
 +
'''Date: 1/03 <br>
 +
'''Revised: 9/03; 6/06; 7/07; 10/08; 1/12; Reviewed: 1/15; Revised: 2/18; 8/18'''<br>
 +
<br>
 +
|-
 +
|
 +
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility'''
 +
|-
 +
|}
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: MEG normal control / volunteer subject selection / screening will conform with MEG best practices criteria.  In addition, MEG guidelines will be consistent with the policy and procedures established by the NIH and the IRB.
  
 +
<br>
 +
'''Procedure:'''
 +
::'''1. Subject Registration'''
 +
::::a. All subjects participating in MEG studies are required to have a valid medical record number (MRN).
  
::'''V. <u>Process Improvement / Variance Reporting</u>'''
+
::::b. It will be the responsibility of the principal investigator (PI) to make sure that all outpatients and control subjects have gone through the appropriate registration process and have a valid MRN.
::::'''1. Process Improvement / User Feedback''' – Users may make suggestions or give feedback to the MEG staff via the Variance Process Improvement Report.  Feedback may also be provided via the MEG Discussion List at MEG_DISCUSSION@LIST.NIH.GOV. 
 
::::'''2. Variance Reporting''' – Users are responsible for reporting complications, incidents, or problems that occur involving the facility via the Variance Process Improvement Report.
 
::::'''3. Equipment Failure''' -Users are also responsible for reporting any equipment failure or any equipment that may not be working properly via the Variance Process Improvement Report.
 
::::'''4. Broken Equipment''' - Any equipment that is inoperable or broken should be tagged with an Out of Service / Do Not Use sticker indicating the date and time taken out of service.  Fill out the sticker including the name of the person making the report, phone number and a brief description of the problem.
 
::::'''5. All non-urgent communications''' will be reported using the Variance / Process Improvement Report.
 
  
 +
::::c. A doctor’s order is not required for an MEG scan but a progress note must be placed in the subject’s chart indicating the nature of the scan performed, the date, time, and protocol number.  The patient’s condition and general performance should also be noted. The progress must also be signed by the appropriate personnel. Progress notes are solely the responsibility of the individual investigators.
  
+
::'''2. Consent Forms'''
::'''VI. <u>Magnetically Shielded Room (MSR) Guidelines</u>'''
+
::::a. An IRB approved consent form must be signed by all subjects prior to participating in any MEG research study.   
::There are no known risks associated with MEG/EEG recordings. Although wearing metal objects while in the MSR (Magnetically Shielded Room) is not harmful to the individual, bringing metal objects in the MSR can result in a poor quality / uninterruptible recordingIn addition, bringing magnetized objects into the MSR can cause trapped flux in the SQUIDS which can lead to long and expensive service to fix causing obvious interruptions and scheduling delays.  Thus, we have established these guidelines:
 
  
::::1. Subjects should not bring any metal objects inside the MSRAny subject entering the MSR must first “de-metal” (remove any metal objects; empty pockets; remove jewelry, hairclips, pens, clipboards etc.). These include belts, keys, watches, rings/earrings, necklaces, coins, eyeglasses and pieces of clothing with metal parts such as bras with under wires or bras with metal adjustment rings.
+
::::b. Investigators are required to satisfy all Clinical Center documentation requirements.   
  
::::2. No one (not subjects / nor MEG Users) should bring electrical equipment inside the MSR.  Objects such as cell phones, pagers, cameras, flashlights, or any other electrical equipment are strictly forbidden.  
+
::::c. It will be the responsibility of the PI to assure that subjects have signed the appropriate consent form.
  
::::3. Magnets and anything magnetized is never allowed inside the MSR by anyone.
+
::'''3. Subject Pre-Screening'''
 +
::::a. Although MEG/EEG poses no known risk to subjects, some subjects will be ruled out for participation in scanning due to factors involving metallic implants or foreign bodies which may prevent obtaining artifact free data.  
  
::::4. No one should wear shoes inside the MSR.  To prevent any metal or magnetic dust from getting into the MSR shoes must be removed before entering the MSR.
+
::::b. It will be the responsibility of the PI to pre-screen subjects for the below listed contraindications during the selection process.  
  
::::5. Any “unapproved” equipment should not be brought into the MSR.  Any “special” equipment must be approved by the director or staff scientist prior to its use.
+
::::::Conditions That Will Rule Out a Subject:
 +
::::::::• Cardiac pacemaker / Cardiac or neural defibrillators
 +
::::::::• Metal fragments in the eyes
 +
::::::::• Metal plates, pins or bolts in head
 +
::::::::• Any magnetic implantation / implantations made from iron (ferrous products)
  
::::6. Do not use small metal objects (i.e., staples, paper clips) around the MSR.
+
::::::An Additional Consideration Which Will Rule Out a Subject:
 +
::::::::• Head size greater than 60 cm: if a subject’s head is too large to fit in the helmet
 +
::::::::• Weight greater than 300lbs (seated recording) or 250lbs (supine recording)
  
::::7. NO equipment will be left in the MSR other than the equipment that belongs in the MSR.
+
::'''4. Subject Screening'''
 +
::::a. Investigators may use the MEG Screening Questionnaire and/or Handedness Form as a subject evaluation / screening tool.  
  
 +
::::b. All MEG subjects should be screened for the following items which may cause recording artifacts.
  
 +
::::::Conditions That May Rule Out a Subject:
 +
::::::::• Surgical aneurysm clips
 +
::::::::• Shrapnel
 +
::::::::• Neurostimulators
 +
::::::::• Implanted pumps (i.e., Insulin pumps)
 +
::::::::• Steel pins from root canals; a permanent retainer
 +
::::::::• Ear implants (certain cochlear implants)
 +
::::::::• Metal rods, plates or screws in the body or mouth
 +
::::::::• Previous surgery (if metal was left in the body)
 +
::::::::• Hearing aids (should be removed before scanning)
 +
::::::::• Braces (causes severe artifact)
 +
::::::::• Tattoos (may have metallic paint)
 +
::::::::• Piercings (may contain metal)
  
<div align="center">_________________________________________________________________________________________________ </div>
+
::::::Other Considerations Which May Rule Out a Subject:
<br>
+
::::::::• Movement disorders (i.e., ticks, restless legs, etc., any condition that may cause excessive movement)
 +
::::::::• Vision / Hearing problems
 +
::::::::• Problems using response devices
 +
 
 +
::::c. The confidentially of the MEG Subject Screening Questionnaires and Handedness Forms will be the primary responsibility of the study’s principal investigator.
  
==== '''Subject Guidelines 3.20''' ====
+
::'''5. Subject Instructions'''
 +
::::a. Users/PI’s are responsible for giving subjects instructions prior to any scheduled procedure. 
 +
 
 +
::::b. Subjects should be informed not to wear these items:
 +
::::::::• Bras with underwires
 +
::::::::• Makeup/moisturizer/sunscreen of any kind
 +
::::::::• Clothing containing metallic (shiny) threads or glitter
 +
::::::::• Metal on clothing (i.e., metal buttons, snaps or trimming)
 +
::::::::• Hearing aids
 +
 +
::::c. Subjects should be informed that metallic/magnetic items should not be taken into the Magnetically Shielded Room (MSR).  These include such items as:
 +
::::::::• Belts
 +
::::::::• Keys
 +
::::::::• Watches
 +
::::::::• Coins
 +
::::::::• Eyeglasses
 +
::::::::• Cell phones
 +
::::::::• Pagers
 +
::::::::• Credit Cards
 +
::::::::• Small metal objects such as hair pins, paper clips, safety pins, etc.
 +
::::::::• Shoes (may have metallic dust particles on them)
 +
 
 +
::::d. It is the responsibility of the PI to inform subjects that if they arrive unprepared i.e., have metallic/magnetic parts on their clothing that cannot be easily removed, they may be asked to change into non-magnetic clothing which will be provided by staff.
 +
 
 +
::::e. If there is any question about whether an object is magnetic, the object is not taken inside the MSR.
 +
<br>
 +
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 +
<br>
 +
 
 +
===<big>'''MEG / EEG Setup Procedures'''</big>===
 +
 
 +
 
 +
===='''MEG Setup / Fiducial Coil Placement Procedures'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 355: Line 437:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Subject Guidelines'''<br>
+
'''MEG / EEG'''<br>
'''Policy No. 3.20'''
+
'''Policy No. 4.00'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Revised: 9/03; 6/06; 7/07; 10/08; 1/12; Reviewed: 1/15; Revised: 2/18'''<br>
+
'''Revised: 9/03; 6/06; 8/07; 10/08; 1/12; 2/18; 8/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 369: Line 451:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: MEG normal control / volunteer subject selection / screening will conform with MEG best practices criteria.  In addition, MEG guidelines will be consistent with the policy and procedures established by the NIH and the IRB.
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''All subjects/patients will be up set for MEG according to standardized procedures in accordance with manufacturer’s specifications.'''
  
<br>
 
 
'''Procedure:'''
 
'''Procedure:'''
::'''1. Subject Registration'''  
+
::1. '''Head Size / Fit Test'''
::::a. All subjects participating in MEG studies are required to have a valid medical record number (Medical Information System /MIS #).
+
::::a. <u>'''''Determine head size'''''</u> by measuring the subject’s head. The Gantry head limits are:
  
::::b. It will be the responsibility of the principal investigator (PI) to make sure that all outpatients and control subjects have gone through the appropriate registration process and have a valid MIS#.
 
  
::::c. A doctor’s order is not required for an MEG scan but a progress note must be placed in the subject’s chart indicating the nature of the scan performed, the date, time, and protocol numberThe patient’s condition and general performance should also be noted. The progress must also be signed by the appropriate personnel.
+
:::::::::::::::::::{| class="wikitable"
 +
|--style="text-align: center;"
 +
| '''Nasion-Inion''' || '''Preauricular Point to<br>Preauricular Point''' || '''Circumference'''
 +
|--style="text-align: center;"
 +
| < 40 cm || < 40 cm || < 59 cm
 +
|}
 +
 +
 +
::::b. <u>'''''Determine fit'''''</u> by placing the MEG helmet along with a protective cap over the subject’s head.   
  
 +
:::::::::::::::::::{| class="wikitable"
 +
|-
 +
| <gallery>
 +
MEG_Sizing_Helmet_1_cropped.png|MEG Sizing Helmet-front
 +
</gallery> || <gallery>
 +
MEG_Sizing_Helmet_2_cropped.jpg|MEG Sizing Helmet-side
 +
</gallery>
 +
|}
  
::'''2. Consent Forms'''
+
::2. '''Fiducial Points/Head Coil Placements'''  
::::a. An IRB approved consent form must be signed by all subjects prior to participating in any MEG research study. 
 
  
::::b. Investigators are required to satisfy all Clinical Center documentation requirements.
+
::::a. If subject has had previous digital pictures of the fiducial points retrieve images and match placement.  
  
::::c. It will be the responsibility of the PI to assure that subjects have signed the appropriate consent form.
+
::::b. A document with images of suggested placement is available here:
 +
:::::* [[Image:word.png]] [[Media:MEG_Fiducial_Placement_Instructions.docx | MEG Fiducial Placement Instructions]]
 +
:::::* [[Image:pdf.png]] [[Media:MEG_Fiducial_Placement_Instructions.pdf | MEG Fiducial Placement Instructions]]
  
 +
::::c. Place a small black dot near the nasion (indentation between the forehead and the nose); between the eyebrows midline.
  
::'''3. Subject Pre-Screening'''
+
::::d. Place a small black dot at the left and right preauricular points centered (about 1.5Cm) in front of the tragus. This should be measured on a straight line from the tip of the tragus to the outer canthus for accuracy.
::::a. Although MEG/EEG poses no known risk to subjects, certain physical conditions may make subjects ineligible to participate in scanning. Some subjects will be ruled out for participation in scanning due to factors involving metallic foreign bodies which may prevent obtaining artifact free data.  
 
  
::::b. It will be the responsibility of the PI to pre-screen subjects for the below listed contraindications during the selection process.  
+
::::e. Take a digital picture of these locations, download and print Place in subject’s MEG file for future reference.
  
::::::Conditions That Will Rule Out a Subject:
+
::::f. Attach a small (MEG) Adhesive Washers to each head localization coil.
::::::::• Cardiac pacemaker / Cardiac or neural defibrillators
 
::::::::• Metal fragments in the eyes
 
::::::::• Metal plates, pins or bolts in head
 
::::::::• Any magnetic implantation / implantations made from iron (ferrous products)
 
  
::::::An Additional Consideration Which Will Rule Out a Subject:
+
::::g. Attach head localization coils at the fiducial marks. Make sure the marks line up with the center of the head coils.
::::::::• Head size greater than 60 cm: if a subject’s head is too large to fit in the helmet
 
  
 +
::::h. Place tape over the coil and the cable to secure.
  
::'''4. Subject Screening'''
 
::::a. Investigators may use the MEG Screening Questionnaire and/or Handedness Form as a subject evaluation / screening tool.
 
  
::::b. All MEG subjects should be screened for the following items which may cause recording artifact.
+
:::::::::::::::::::::::'''MEG HEAD COIL PLACEMENTS'''
 +
::::::::::::::::::{| class="wikitable"
 +
|-style="text-align: center;"
 +
| '''RIGHT <br>PRE-AURICULAR POINT''' || '''NASION''' || '''LEFT <br>PRE-AURICULAR POINT'''
 +
|-style="text-align: center;"
 +
| Red || Yellow || Blue
 +
|}
  
::::::Conditions That May Rule Out a Subject:
+
References:
::::::::• Surgical aneurysm clips
+
::1. NIMH MEG Core Facility Data Tutorial Manual
::::::::• Shrapnel
+
::2. MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc.  
::::::::• Intra-orbital metallic structures
 
::::::::• Neurostimulator
 
::::::::• Implanted pumps (i.e., Insulin pumps)
 
::::::::• Steel pins from root canals; a permanent retainer
 
::::::::• Ear implants (certain cochlear implants)
 
::::::::• Metal rods, plates or screws in the body or mouth
 
::::::::• Previous surgery (if metal was left in the body)
 
::::::::• Hearing aids (should be removed before scanning)
 
::::::::• Braces (causes severe artifact)
 
::::::::• Tattoos (may have metallic paint)
 
::::::::• Piercings (may have metallic ink)
 
  
::::::Other Considerations Which May Rule Out a Subject:
 
::::::::• Head size: if a subject’s head is too fit in the helmet
 
::::::::• Movement disorders (i.e., ticks, restless legs, etc., any condition that may cause excessive movement)
 
::::::::• Vision / Hearing problems
 
::::::::• Problems using response devices
 
  
  
::::c. The confidentially of the MEG Subject Screening Questionnaires and Handedness Forms will be the primary responsibility of the study’s principal investigator.
+
<div align="center">______________________________________________________________________________________________________________________________ </div>
 +
<br>
  
 +
===='''EEG Easy Cap Setup Procedures'''====
 +
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''EEG Easy Cap Setup Procedures'''<br>
 +
'''Policy No. 4.20'''
 +
|style="width: 650px"|
 +
'''Date: 1/03 <br>
 +
'''Reviewed: 9/03; 6/06; 8/07; 10/08; 1/12; 1/15; Revised: 2/18'''<br>
 +
<br>
 +
|-
 +
|
 +
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility'''
 +
|-
 +
|}
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The EEG Easy Cap will be used per manufacturer’s guidelines and recommendations.'''
  
::'''5. Subject Instructions'''
 
::::a. Users/PI’s are responsible for giving subjects instructions prior to any scheduled procedure. 
 
  
::::b. Subjects should be informed not to wear these items:
 
::::::::• Bras with underwires
 
::::::::• Makeup (mascara, eye liner, eye shadow)
 
::::::::• Clothing containing metallic (shiny) threads or glitter
 
::::::::• Metal on clothing (i.e., metal buttons, snaps or trimming)
 
 
::::c. Subjects should be informed that metallic/magnetic items should not be taken into the Magnetically Shielded Room (MSR).  These include such items as:
 
::::::::• Belts
 
::::::::• Keys
 
::::::::• Watches
 
::::::::• Coins
 
::::::::• Eyeglasses
 
::::::::•Cell phones
 
::::::::• Pagers
 
::::::::• Credit Cards
 
::::::::• Small metal objects such as hair pins, paper clips, safety pins, etc.
 
::::::::• Shoes (may have metallic dust particles on them)
 
  
::::d. It is the responsibility of the PI to inform subjects that if they arrive unprepared i.e., have metallic/magnetic parts on their clothing that cannot be easily removed, they may be asked to change into non-magnetic clothing which will be provided by staff.
+
::'''Procedure:'''
 +
 
 +
<br>
 +
::'''A.  Head Size / Fit Test'''
 +
::::1. Determine head size by measuring the subject’s head. 
 +
 
 +
::::2. Select cap size:  Small (< 56 cm); Medium (< 58 cm); Large (< 60cm).
 +
 
 +
::::3.  Determine MEG gantry fit by placing the MEG sizing helmet along with a protective cap over the subject’s head.
  
::::e. If there is any question about whether an object is magnetic, the object is not taken inside the MSR.
 
  
 +
::'''B.  Measuring & Marking Head'''
 +
::::1.  Measure and mark FP1, FP2, FPz and Cz.
  
  
 +
::'''C.  Mounting the Cap'''
  
 +
::::1.  Rotate the adaptors in cap so that the narrow opening is toward the back of the head.
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
+
::::2.  Place anchoring adhesive washer on Fp1 & Fp2.
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 
<br>
 
  
===<big>'''MEG / EEG (4.00)'''</big>===
+
::::3.  Press Fp1 & Fp2 onto adhesive washers.  Have subject hold Fp1 & Fp2 in place while turning cap over the head.  Gently pull cap over the head and ears into place.
  
 +
::::4.  Check and adjust cap so that the Cz electrode is at the Cz mark.
  
===='''MEG / EEG Setup Procedures 4.00'''====
+
::::5.  Check Fp1 & FP2 and O1 & O2 to assure that they are placed correctly, if not choose another cap size.
'''National Institute of Mental Health'''
+
 
{| class="wikitable"
+
::::6.  Anchor the cap either with the chest belt or the chin strap. 
|style="width: 350px"|
+
 
'''Subject:'''<br>
+
::::7.  Snap electrodes into the adaptors in a systematic manner starting at the back of the head.  Insert so that the lead wire points towards the narrow side of the adaptor. 
'''MEG Core Facility'''<br>
+
 
'''MEG / EEG'''<br>
+
::::8.  Push electrode into the adaptor with the fingers or with the aid of an old ballpoint pen where the mine (point) has been removed.  Pay attention not to bend or place excessive pressure on the lead wire where it attaches to the electrode.
'''Policy No. 4.00'''
+
 
 +
 
 +
 
 +
<div align="center">______________________________________________________________________________________________________________________________ </div>
 +
 
 +
<br>
 +
 
 +
===='''Electrode Required for PI owned EEG systems '''====
 +
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Electrode Specifications'''<br>
 +
'''Policy No. 4.30'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Revised: 9/03; 6/06; 8/07; 10/08; 1/12; 2/18'''<br>
+
'''Reviewed: 9/03; 6/06; Revised: 9/07; 10/08; 1/12; 1/15; Revised: 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 490: Line 598:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''All subjects/patients will be up set for MEG according to standardized procedures in accordance with manufacturer’s specifications.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Electrodes used for MEG and EEG will meet CTF's guidelines and recommendations.'''
 +
<br>
 +
'''Procedure:'''
 +
<br>
 +
::For large electrode arrays the use of an electrode cap system, as provided by the MEG Core Facility, is recommended. However, alternative methods of electrode application may be used.  Additionally, electrodes can be glued or pasted to the scalp using various types of electrodes. Because of the different properties of the various metals used for electrodes careful attention should be given to the choice of electrode material.  These and other factors need to be considered when choosing electrodes for any MEG/EEG application.  Below are the recommendations for electrode selection:
 +
 
 +
::1.  Silver/Silver-Chloride (Ag/AgCl) electrodes are recommended to take advantage of the DC response of the EEG amplifiers.
  
'''Procedure:'''
+
::2. Sintered electrodes are preferred to avoid chloriding the electrodes after every few uses.  
::1. '''Head Size / Fit Test'''
 
::::a. <u>'''''Determine head size'''''</u> by measuring the subject’s head. The Gantry head limits are:
 
  
 +
::3.  It is recommended that the lead length be at least 1.4 meters (48 inches) to allow the amplifier to be reasonably far away from the MEG sensors.
  
:::::::::::::::::::{| class="wikitable"
+
::4. The material in the electrodes and associated connectors should be non-magnetic.
|--style="text-align: center;"
 
| '''Nasion-Inion''' || '''Preauricular Point to<br>Preauricular Point''' || '''Circumference'''
 
|--style="text-align: center;"
 
| < 40 cm || < 40 cm || < 59 cm
 
|}
 
 
 
::::b. <u>'''''Determine fit'''''</u> by placing the MEG helmet along with a protective cap over the subject’s head.
 
  
:::::::::::::::::::{| class="wikitable"
+
::5. The thickness of the EEG electrode should be minimal to avoid fitting problems in the MEG helmet.
|-
 
| <gallery>
 
MEG_Sizing_Helmet_1_cropped.png|MEG Sizing Helmet-front
 
</gallery> || <gallery>
 
MEG_Sizing_Helmet_2_cropped.jpg|MEG Sizing Helmet-side
 
</gallery>
 
|}
 
  
::2. '''Fiducial Points/Head Coil Placements''' <br>*If subject has had previous digital pictures of the fiducial points retrieve images and match placement.  
+
::6. Electrodes should have the DIN style connector.
  
::::a. Place a small black dot near the nasion (indentation between the forehead and the nose); between the eyebrows midline.
 
  
::::b. Place a small black dot at the left and right preauricular points centered (about 1.5Cm) in front of the tragus. This should be measured on a straight line from the tip of the tragus to the outer canthus for accuracy.
+
Reference:
 +
::1. CTF MEG System Operation and Technical Reference Manual (P/N 900-0028), VSM MedTech Ltd.
  
::::c. Take a digital picture of these locations, download and print Place in subject’s MEG file for future reference. 
 
  
::::d. Attach a small (MEG) Adhesive Washers to each head localization coil.
+
<div align="center">______________________________________________________________________________________________________________________________ </div>
  
::::e. Attach head localization coils at the fiducial marks.  *Make sure the marks line up with the center of the head coils. Place the:
 
 
::::f. Place tape over the coil and the cable to secure.
 
 
 
:::::::::::::::::::::::'''MEG HEAD COIL PLACEMENTS'''
 
::::::::::::::::::{| class="wikitable"
 
|-style="text-align: center;"
 
| '''RIGHT <br>PRE-AURICULAR POINT''' || '''NASION''' || '''LEFT <br>PRE-AURICULAR POINT'''
 
|-style="text-align: center;"
 
| Red || Yellow || Blue
 
|}
 
 
 
 
References:
 
::1. NIMH MEG Core Facility Data Tutorial Manual
 
::2. MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc.
 
 
 
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
 
<br>
 
<br>
  
===='''EEG Easy Cap Setup Procedures 4.20'''====
+
===='''Fudicial Points Digital Images'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 556: Line 631:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''EEG Easy Cap Setup Procedures'''<br>
+
'''Fudicial Points Digital Images - Cannon A1400 Digital Camera'''<br>
'''Policy No. 4.20'''
+
'''Policy No. 4.60'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 9/03; 6/06; 8/07; 10/08; 1/12; 1/15; Revised: 2/18'''<br>
+
'''Reviewed: 9/03; 6/06; 9/07; 10/08; 1/12; 1/14; 1/15; Revised: 5/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 570: Line 645:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The EEG Easy Cap will be used per manufacturer’s guidelines and recommendations.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''Digital images of the fudicial points will be taken in order to co-register MRI data. The digital camera will be utilized in accordance with manufacturer’s guidelines.'''
  
 +
Three or four views will be taken: 1) Right tragus fiducial point position; Left tragus fiducial point position; Nasion position (on the forehead between the eyebrows); and 4) subject full view '''(this picture is optional)'''.
 +
 +
'''Procedure:'''
  
 +
::'''1.  TURN ON THE POWER'''
  
::'''Procedure:'''
+
::::::a.  Press the power button.'''
  
<br>
+
::'''2FOCUSING AN IMAGE:'''
::'''AHead Size / Fit Test'''
+
::::::aTo FOCUS / FRAME images (especially when taking close-up-shots) use the SHUTTER BUTTON.
::::1Determine head size by measuring the subject’s head.
 
  
::::2Select cap size:  Small (< 56 cm); Medium (< 58 cm); Large (< 60cm).
+
::::::bFrame the picture in the IMAGE DISPLAY (for a close up; with the camera about 12 inches away from the object).
  
::::3Determine MEG gantry fit by placing the MEG sizing helmet along with a protective cap over the subject’s head.
+
::::::cPress the ZOOM IN BUTTON  then
  
 +
::::::d.  Press and hold the SHUTTER BUTTON (large round silver button) halfway down to allow the camera to adjust the focus and exposure, then 
  
::'''B.  Measuring & Marking Head'''
 
::::1.  Measure and mark FP1, FP2, FPz and Cz.
 
  
 +
::'''3.  TAKING A PICTURE:'''
 +
::::::a.  Press the SHUTTER BUTTON <u>all the way down</u> to take the picture. 
  
::'''C.  Mounting the Cap'''
 
  
::::1Rotate the adaptors in cap so that the narrow opening is toward the back of the head.
+
::'''4.  VIEWING IMAGES:'''
 +
::::::aPress the MENU / PLAY button to turn on the image display.  The last picture you took or viewed appears on the image display.
  
::::2Place anchoring adhesive washer on Fp1 & Fp2.  
+
::::::bUse the CONTROLLER (OK) to scroll through the images.
  
::::3Press Fp1 & Fp2 onto adhesive washers.  Have subject hold Fp1 & Fp2 in place while turning cap over the head.  Gently pull cap over the head and ears into place.
+
::::::cAfter reviewing the images, press the PREVIEW BUTTON to turn off the image display.
  
::::4.  Check and adjust cap so that the Cz electrode is at the Cz mark.
 
  
::::5Check Fp1 & FP2 and O1 & O2 to assure that they are placed correctly, if not choose another cap size.
+
::'''5.  UPLOADING  / PRINTING images:'''
 +
::::::aTurn camera OFF.  
  
::::6Anchor the cap either with the chest belt or the chin strap.
+
::::::bConnect the camera via the USB cable to a computer running Windows with the HP camera software (Ebi).
  
::::7Snap electrodes into the adaptors in a systematic manner starting at the back of the head.  Insert so that the lead wire points towards the narrow side of the adaptor.
+
::::::cTurn the camera on.  
  
::::8Push electrode into the adaptor with the fingers or with the aid of an old ballpoint pen where the mine (point) has been removedPay attention not to bend or place excessive pressure on the lead wire where it attaches to the electrode.
+
::::::dOpen the HP Photo Imaging Software by double clicking on the icon on the desktop.
 +
 
 +
::::::e.  Right click then select "MOUNT VOLUME".
 +
 
 +
::::::f.  Open the DCIM folder.
 +
 
 +
::::::g.  Open the FOLDER labelled "152_(number for the current month); Jan=1, Feb=2... 
 +
 
 +
::::::hCopy pictures and drag to the appropriate "USER" folder.  If you don't have a user folder first create one. 
 +
 
 +
::::::i.  Rename the pictures by date taken (Example, 20151201a, 20151201b, 20151201c, etc.
 +
 
 +
::::::j.  Deletes all pictures from the Camera - if you delete the pictures from the DCIM Folder this will delete your pictures from the camera.
 +
 
 +
::::::k.  Right click to UNMOUNT the volume.
 +
 
 +
::::::l. Unplug the camera.
 +
 
 +
::::::m. Turn off camera.
 +
 
 +
::::::n. Log out of the computer.
 +
 
 +
 
 +
::'''6.  PRINTING IMAGES:
 +
 
 +
::::::a.  Select pictures to be printed.
 +
 
 +
::::::b.  Right Click then sleect OPEN with --> '''PhotoPrint'''.  Or Left Click on FILE then --> Select '''Open with PhotoPrint'''.
 +
 
 +
::::::c.  Click on FILE then --> /Select '''PRINT SETUP'''.
  
 +
::::::d.  Select "COLOR" as the printer (the HP Laserjet Printer near the Stimulus Computer).
  
  
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 +
  
 
<br>
 
<br>
  
===='''Electrode Specifications 4.30'''====
+
===='''EEG Impedance Check on the MEG System'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 619: Line 729:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Electrode Specifications'''<br>
+
'''EEG Impedance Check on the MEG System'''<br>
'''Policy No. 4.30'''
+
'''Policy No. 4.70'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 9/03; 6/06; Revised: 9/07; 10/08; 1/12; 1/15; Revised: 2/18'''<br>
+
'''Reviewed: 9/03; Revised: 6/06; 9/07; 10/08; 1/12; 1/15; 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 633: Line 743:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Electrodes used for MEG and EEG will meet CTF's guidelines and recommendations.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''When performing EEG, the electrode impedance will be checked using the MEG acquisition software to ensure that impedances are within acceptable levels.'''
  
'''For large electrode arrays the use of an electrode cap system is recommended, however, alternative methods of electrode application may be usedAdditionally, electrodes can be glued or pasted to the scalp using various types of electrodes. But because of the different properties of the various metals used for electrodes careful attention should be given to the choice of electrode materialThese and other factors need to be considered when choosing electrodes for any MEG/EEG applicationBelow are the recommendations for electrode selection:'''
+
<br>
 +
After the electrodes are attached to the subject’s scalp / electrode cap placed, the electrode impedance(s) will be checked to ensure good contactThe impedances measured should only be used to judge scalp contact and should not be considered a precise measure of actual impedance. Ideal impedances for scalp electrodes typically range from 1-5kohmsImpedances for other non-cerebral electrodes ideally should be < 50kohms.   
 +
 
 +
<br>
 +
'''Procedure:'''
  
 +
::::1.  Attach electrodes to the scalp / place cap.
  
::1Silver/Silver-Chloride (Ag/AgCl) electrodes are recommended to take advantage of the DC response of the EEG amplifiers.
+
::::2Touch the static discharge button before connecting electrodes or cap connector jig to the amplifier unit. Connect the electrodes or electrode cap to the amplifier unit.  
  
::2Sintered electrodes are preferred to avoid chloriding the electrodes after every few uses.  
+
::::3Launch ACQ - Run the appropriate EEG program.
  
::3It is recommended that the lead length be at least 1.4 meters (48 inches) to allow the amplifier to be reasonably far away from the MEG sensors.
+
::::4Select the EEG Setup Window menu.
  
::4The material in the electrodes and associated connectors should be non-magnetic.
+
::::5Highlight desired channels.
  
::5The thickness of the EEG electrode should be minimal to avoid fitting problems in the MEG helmet.
+
::::6Click on CHECK IMPEDANCE.
  
::6Electrodes should have the DIN style connector.
+
:::::::aThe results are displayed in the appropriate columns.
 +
:::::::b.  To check the impedance of all active EEG channels, press the CTRL key on the keyboard at the same time as clicking on the impedance check button.
 +
:::::::c.  Please note: The impedance check requires 3 electrodes: The electrode being measured and at least 2 other electrodes.
  
 +
::::7.  Click OK / EXIT. 
  
Reference:
 
::1.  CTF MEG System Operation and Technical Reference Manual (P/N 900-0028), VSM MedTech Ltd. 
 
  
 +
''Reference:''
 +
::::''1.  Data Acquisition Manual, p/n 900-0006, CTF Systems Inc. (www.ctf.com).''
  
  
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 +
  
 
<br>
 
<br>
  
===='''Polhemus Digitizatin System 4.40'''====
+
===='''EEG Impedance Check using the Grass Impedance Meter'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 666: Line 785:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Polhemus Digitization System'''<br>
+
'''EEG Impedance Check using the Grass Impedance Meter'''<br>
'''Policy No. 4.40'''
+
'''Policy No. 4.75'''
<font color="red">'''CURRENTLY UNDER REVIEW</font>
 
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Revised: 9/03; Reviewed: 6/06; 9/07; 10/08; 1/12; 1/15; 2/18'''<br>
+
'''Reviewed: 9/03; 10/03; Revised: 6/06; 9/07; 10/08; 1/12; 1/15; 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 681: Line 799:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Polhemus Digitizer is used for the digitization of the EEG electrode positions and for the determination of head shape. EEG electrodes will be digitized using the Polhemus according to standardized procedures in accordance with manufacturer's specifications.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''When performing EEG, the electrode impedance will be checked using the Grass Impedance Meter to ensure adequate electrode contact with the scalp.'''
 +
 
 +
An external impedance check should be performed on all electrodes used for EEG, EOG or EMG using the Grass S88 Impedance Meter.  The Grass Impedance Meter measures AC impedance (resistance and capacitance).  When two or more electrodes are plugged into the electrode switch positions, all electrodes except the one selected electrode being measured are connected and provide the reference for the one being measured.
  
 +
To perform an Impedance Check, at least two electrodes are required to be plugged in to the impedance meter.
  
 
'''Procedure:'''
 
'''Procedure:'''
 +
::::1.  The Electrode Selector Switch should be at position 1 - 10.
  
::1Mark the fiducial points (nasion, left & right preauricular points).
+
::::2Plug the ground electrode (Grd) into electrode jack 1 position.  
  
::2Take a digital picture of those points.  Download to computer and print pictures.
+
::::3Plug the other electrode(s) into the jack positions 2 - 10 in a systematic manner.
  
::3Mount the Easy Cap on the subject.  *Refer to the Easy Cap instructions.
+
::::4Press the Red ON Button to activate the impedance check.  *The power will automatically shutoff after approximately 2 minutes. (There is no OFF button.)
  
::4Place the small Receiver Module at the top of the cap / head midlineSecure with tape.
+
::::5If the impedance is too high:
 
+
:::::::aTake a cotton tip swab dipped in Nuprep (Abralyt or other skin prep) and twirl against the skin.  
::5Place the large transmitter on a non-metallic stand midline behind the subjectTape the transmitter to the stand to secure.
+
:::::::bRe-insert electrolyte.
 
+
:::::::cRe-measure impedance.
::6.  Turn on the laptop computer:
+
:::::::dRepeat this process until all impedances are within acceptable levels.
::::aDouble click on Electrode Digitizer Program.  The software should detect two (2) stations if not check the connections then restart the program.
 
  
::::b.  In order to start - Define the Head Coordinate System. 
+
:::::::::::::::::::::'''Impedance Recommendations'''
::::::•  Press the button on the Stylus Pen to begin.
+
:::::::::::::::::::{| class="wikitable"
::::::•  To define the (head) coordinates (locate each head coil position) - Place the stylus pen tip at the center of the head coil location <br>(nasion, left preauricular, right preauricular) then
 
::::::•  Press the stylus button.
 
 
 
::::c.  To begin Digitization – From the Laptop/Computer: Click on Digitizing Start/Stop.
 
::::::•  Digitize all electrode positions by placing the stylus pen at the center of each electrode location then pressing the stylus button. 
 
::::::::::—A single data point is collected each time the stylus button is depressed and a beep will alert the user to each acquired point. 
 
::::::::::—The program will assign a number to the electrode position in the sequence that the electrodes are selected, I.e., 1, 2, 3, 4, etc.
 
 
 
::::::•  Click on Digitizing Start / Stop when done.
 
 
 
::::::•  If a mistake is made:
 
::::::::::i)  Press the stylus pen until all head coordinates have been entered then,
 
::::::::::ii)  Press define Head Coordinates again.  Do not save the previously acquired <br> locations simply, start over from the beginning.
 
 
 
::::d.  Verify Digitization Accuracy.  Review the diagram of the electrode placements which appears on the monitor.  If the diagram is:
 
::::::•  Correct then click on continue.
 
::::::•  Not correct check to make sure that the receiver or transmitter did not move and repeat digitization.
 
 
 
::7.  Click on File / Save Menu.
 
 
 
::8.  Save the data to the Laptop hard drive and
 
 
 
::9.  Save the data to a floppy disk.  The filename is the current date.
 
 
 
::10.  Exit the program.  Eject disk.  Turn off laptop.
 
 
 
::11.  Transfer Polhemus head coordinate file to computer at acquisition workstation / console.
 
 
 
 
 
:::''Note:  The operator and anyone within 10 feet of the transmitter and receiver should de-metal.  The general rule of thumb is three times the separation distance between the transmitter and receiver from any metal in the room.  For example, if the separation distance is one foot, metal within three feet of the transmitter or receiver may cause distortion and inaccurate measurements.''
 
 
 
 
 
 
 
 
 
 
 
::::::::::{| class="wikitable"
 
 
|-
 
|-
 
+
| EEG Electrodes || 5-10K ohms
! Transferring the Polhemus Digitization File to the Acquisition Computer
 
 
|-
 
|-
|  
+
| EMG Electrodes (EOG, ECG, etc.) || < 50K ohms
::1.  Insert the memory stick with the digitization file into input of the Acquisition Computer (Squid).
+
|}
::2.  On the Acquisition Computer, open a new terminal window and cd to your user directory. This will be something like: 
 
::::::::'''''cd users/<username>'''''
 
::3.  Copy the file using mcopy:
 
::::::::'''''mcopy a:YYYYMMDD.pos'''''
 
::4.  Refer to your montage file which should display the labels for the EEG electrodes <br>in the order in which they were digitized. This file looks something like this:
 
::::::::::::::::1.  fp1
 
::::::::::::::::2.  fp2
 
::::::::::::::::3.  f7
 
::::::::::::::::4.  f3
 
::::::::::::::::5.  fz
 
::::::::::::::::6.  f4
 
::::::::::::::::7.  f8
 
  
::::::::::::::::and should be called:     <something>.layout (e.g., “10-20.layout”).
+
::::6.  If the impedance exceeds 199.9K ohm, a “1” will appear in the left display window with all other digits blanked out indicating that the impedance is too high to be read:
 +
:::::::a.  Take a cotton tip swab dipped in Nuprep (Abralyt or other skin prep) and twirl against the skin.
 +
:::::::bRe-insert electrolyte.
 +
:::::::c. Re-measure impedance.
 +
:::::::d. Repeat this process until all impedances are within acceptable levels.
  
::5.  Run the mkeeglayout.py program to create a .eeg file:
 
::::::::'''''mkeeglayout.py -l <something>.layout  YYYYMMDD.pos'''''
 
  
::6.  This will create '''''YYYYMMDD.eeg'''''.
+
''Reference:''
::7In Acq, click on the '''''“Window / EEG Channel Parameters”''''' menu.
+
''1Grass EZM Electrode Impedance Meter Instructions Manual, Grass Instrument Division, Astro-Med, Inc.''
::8.  Click on the '''''“File / Open EEG File”''''', and enter the .eegfilename.
 
::9.  Highlight all the EEG channels by clicking and dragging.
 
::10. Select '''''“Accept New Attribute Values”'''''.
 
::11.  Impedances may also be checked from this screen or Exit.
 
  
::::::::::::::::::::::::::::::::Rev 4/12/18
+
<br>
 +
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 +
<br>
  
|}
+
===<big>'''Magnetically Shielded Room (MSR) & Subject Support'''</big>===
  
 
+
==== '''Magnetically Shielded Room (MSR)''' ====
 
+
'''National Institute of Mental Health'''
Reference:
+
{| class="wikitable"
::1. Polhemus Fastrak System (http://www.polhemus.com/fastrak.htm).
+
|style="width: 350px"|
 
 
 
 
 
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
 
 
<br>
 
 
 
===='''Fudicial Points Digital Images 4.60'''====
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
|style="width: 350px"|
 
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Fudicial Points Digital Images - Cannon A1400 Digital Camera'''<br>
+
'''Magnetically Shielded Room (MSR'''<br>
'''Policy No. 4.60'''
+
'''Policy No. 5.00'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 9/03; 6/06; 9/07; 10/08; 1/12; 1/14; 1/15; Revised: 5/18'''<br>
+
'''Reviewed: 9/03; 10/03; Revised: 6/06; Reviewed: 9/07; 10/08; 1/12; 1/15; 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 803: Line 864:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''Digital images of the fudicial points will be taken in order to co-register MRI data. The digital camera will be utilized in accordance with manufacturer’s guidelines.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Magnetically Shielded Room (MSR) will be utilized in accordance with manufacturer's recommendations and MEG Core guidelines.'''
  
Three or four views will be taken: 1) Right tragus fiducial point position; Left tragus fiducial point position; Nasion position (on the forehead between the eyebrows); and 4) subject full view '''(this picture is optional)'''.
 
 
'''Procedure:'''
 
  
::'''1TURN ON THE POWER'''
+
'''I<u>MSR Room Lighting</u>'''
 
+
::'''Turning on the lights in the MSR:'''
::::::a.  Press the power button.'''
+
::::*Depress the square green button on the VAC Power Supply Unit which is located on the bottom shelf of the equipment stand outside the MSR.
 +
::'''Dimming the lights in the MSR:'''
 +
::::*Use the Brightness (black) knob to dim the light.
  
::'''2.  FOCUSING AN IMAGE:'''
 
::::::a.  To FOCUS / FRAME images (especially when taking close-up-shots) use the SHUTTER BUTTON.
 
  
::::::bFrame the picture in the IMAGE DISPLAY (for a close up; with the camera about 12 inches away from the object).
+
<br>
 
+
'''II.  <u>MSR Door Operation</u>'''
::::::c.  Press the ZOOM IN BUTTON  then
+
::'''Closing the Door:'''
 +
::::1Push the door up to the door frame as far as possible. 
 +
::::2.  Press the OPEN/CLOSE BUTTON (Black Button) until the air locks activate and the door begins to close then quickly release the button to seal the door.
 +
             
 +
::'''Opening the Door:'''
 +
::::1.  Press the OPEN/CLOSE BUTTON (Black Button) until the air locks release and the door begins to open then quickly release the button.
 +
::::2. Pull the door open.
  
::::::dPress and hold the SHUTTER BUTTON (large round silver button) halfway down to allow the camera to adjust the focus and exposure, then   
+
::'''Door Emergency Operation:'''
 +
::::1Emergency Door Open Button - If the door fails to open, press the EMERGENCY OFF BUTTON (red button) located on the wall outside of the MSR.  There is also an EMERGENCY OFF BUTTON located on the inside of the MSR door.
 +
::::2.  Emergency Door Open Key - If the door fails to open when using the Emergency Off Button, then insert the EMERGENCY DOOR KEY in the upper and lower Emergency Unlock (yellow) keyholes and turn.  This will manually release the door locks. Keys and keyholes are located on both sides of the MSR door.
  
  
::'''3TAKING A PICTURE:'''
+
<br>
::::::a.  Press the SHUTTER BUTTON <u>all the way down</u> to take the picture.   
+
'''III.  <u>MSR Monitors</u>'''
 +
::'''AOxygen Monitor'''
 +
::The Safetnet Oxygen Monitor which is mounted in the MEG Lab on the wall just outside the MSR measures the percentage of oxygen in the MEG lab which may be an indication of the air exchange in the MSR and/or the general integrity of the Dewar and related equipmentRefer to Policy No. 10.15 Daily System Monitors / Quality Assurance.
  
 +
<br>
 +
::'''B.  He Gas Flow Meter'''
 +
::The Gilmont Gas Flow Meter is located inside the MSR mounted on the back left wall. It monitors the MEG Dewar helium level or rate of Helium boil off which gives an indication of the general integrity of the MEG Dewar and related equipment. Refer to Policy No. 10.15 Daily System Monitors / Quality Assurance.
  
::'''4VIEWING IMAGES:'''
+
<br>
::::::a. Press the MENU / PLAY button to turn on the image display. The last picture you took or viewed appears on the image display.
+
::'''CLiquid Helium Level'''
 +
::The AMI Model 135 Liquid Helium Level Monitor which is located on the stand just outside the MSR measures the amount of helium inside the MEG Dewar. Refer to Policy No. 10.15 Daily System Monitors / Quality Assurance.
  
::::::b.  Use the CONTROLLER (OK) to scroll through the images.
 
  
::::::c.  After reviewing the images, press the PREVIEW BUTTON to turn off the image display.
 
  
  
::'''5.  UPLOADING  / PRINTING images:'''
 
::::::a.  Turn camera OFF.
 
  
::::::bConnect the camera via the USB cable to a computer running Windows with the HP camera software (Ebi).
+
'''''References:'''''
 +
::1.  VacuumSchmelze.
 +
::2MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
  
::::::c.  Turn the camera on.
 
  
::::::d.  Open the HP Photo Imaging Software by double clicking on the icon on the desktop.
+
<div align="center">______________________________________________________________________________________________________________________________ </div>
  
::::::e.  Right click then select "MOUNT VOLUME".
 
  
::::::f.  Open the DCIM folder.
+
<br>
  
::::::g.  Open the FOLDER labelled "152_(number for the current month); Jan=1, Feb=2... 
+
===='''Gantry Operation'''====
 
+
'''National Institute of Mental Health'''
::::::h.  Copy pictures and drag to the appropriate "USER" folder.  If you don't have a user folder first create one. 
+
{| class="wikitable"
 
 
::::::i.  Rename the pictures by date taken (Example, 20151201a, 20151201b, 20151201c, etc.
 
 
 
::::::j.  Deletes all pictures from the Camera - if you delete the pictures from the DCIM Folder this will delete your pictures from the camera.
 
 
 
::::::k.  Right click to UNMOUNT the volume.
 
 
 
::::::l. Unplug the camera.
 
 
 
::::::m. Turn off camera.
 
 
 
::::::n. Log out of the computer.
 
 
 
 
 
::'''6.  PRINTING IMAGES:
 
 
 
::::::a.  Select pictures to be printed.
 
 
 
::::::b.  Right Click then sleect OPEN with --> '''PhotoPrint'''.  Or Left Click on FILE then --> Select '''Open with PhotoPrint'''.
 
 
 
::::::c.  Click on FILE then --> /Select '''PRINT SETUP'''.
 
 
 
::::::d.  Select "COLOR" as the printer (the HP Laserjet Printer near the Stimulus Computer).
 
 
 
 
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
 
 
 
 
<br>
 
 
 
===='''EEG Impedance Check on the MEG System 4.70'''====
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
 
|style="width: 350px"|
 
|style="width: 350px"|
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''EEG Impedance Check on the MEG System'''<br>
+
'''Gantry Operation'''<br>
'''Policy No. 4.70'''
+
'''Policy No. 5.20'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 9/03; Revised: 6/06; 9/07; 10/08; 1/12; 1/15; 2/18'''<br>
+
'''Reviewed: 9/03; 10/03;  Reviewed: 6/06; 9/07; 10/08; 1/12; 1/15; Revised: 2/18; 8/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 901: Line 936:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''When performing EEG, the electrode impedance will be checked using the MEG acquisition software to ensure that impedances are within acceptable levels.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The MEG Gantry will be used and maintained in accordance with manufacturer's specifications and MEG Core guidelines.'''
 +
 
  
<br>
 
After the electrodes are attached to the subject’s scalp / electrode cap placed, the electrode impedance(s) will be checked to ensure good contact.  The impedances measured should only be used to judge scalp contact and should not be considered a precise measure of actual impedance. Ideal impedances for scalp electrodes typically range from 1-5kohms.  Impedances for other non-cerebral electrodes ideally should be < 50kohms. 
 
 
<br>
 
 
'''Procedure:'''
 
'''Procedure:'''
 +
 +
There are two Gantry controls which are located on the side of the Gantry base: 1) the '''''Brake Lever''''' and, 2) the '''''Tilt Control Lever'''''. The Gantry controls have been designed so that the operator is required to use two hands to operate.
  
::::1Attach electrodes to the scalp / place cap.
+
::::'''''Please note:'''''
 +
::::::•  The Brake Lever and the Tilt Control Lever must be engaged more-or-less at the same time.  
 +
 
 +
::::::• Pulling up on the '''<u>Brake Lever</u>''' turns on the power and releases the brake.
  
::::2. Touch the static discharge button before connecting electrodes or cap connector jig to the amplifier unit. Connect the electrodes or electrode cap to the amplifier unit.  
+
::::::• Releasing the '''<u>Brake Lever</u>''' engages the lock and turns off the power.
  
::::3. Launch ACQ - Run the appropriate EEG program.
+
::::::• The '''<u>Tilt Control Lever</u>''' is OFF when in the center position.
  
::::4.  Select the EEG Setup Window menu.
 
  
::::5.  Highlight desired channels.
 
  
::::6.  Click on CHECK IMPEDANCE. 
+
'''<u>To re-position / move the Gantry - lift the Brake Lever and hold it in the up position then:</u>'''
  
:::::::aThe results are displayed in the appropriate columns.
+
::1If raising the gantry,  
:::::::b.  To check the impedance of all active EEG channels, press the CTRL key on the keyboard at the same time as clicking on the impedance check button.
 
:::::::c.  Please note: The impedance check requires 3 electrodes: The electrode being measured and at least 2 other electrodes.
 
  
::::7Click OK / EXIT.   
+
::::aWhile still holding the Brake Lever in the release (up) position, lift the Tilt Control Lever handle until the brake is released. You might hear a click or feel the pressure release. Maintain this position until the desired angle of tilt is reached. 
 +
::::b.  As the Tilt Control Lever handle is lifted further the gantry will begin to rise faster.
 +
::::c.  When the angle of tilt is reached first release the Tilt Control Lever and then release the Brake Lever.
 +
 
 +
<br>
 +
::2If lowering the gantry,
  
 +
::::a.  While still holding the Brake Lever in the release (up) position, lift the Tilt Control Lever handle to raise the gantry up a few degrees until you hear the click or the Dewar begins to move in the upward direction. This action will release the brake then allow the gantry to lower.
 +
::::b.  Then push the Lever in the downward direction.  Pushing the Tilt Control Lever handle down will cause the gantry to lower.
 +
 
 +
<br>
 +
::4.  Returning the Tilt Control Lever to the center “OFF” position will cause the gantry motion to slow to a stop.
  
''Reference:''
+
<br>
::::''1Data Acquisition Manual, p/n 900-0006, CTF Systems Inc. (www.ctf.com).''
+
::5Release the brake lever allowing it to go back to the horizontal position to turn off the power and engage / lock the brake.
  
 +
::6.  Never operate the gantry when a subject is seated in the chair or on the bed.
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
  
 +
::::::::::::::::::::'''Gantry Recording Positions'''
 +
::::::::::::::::::{| class="wikitable"
 +
|-
 +
| Sitting Position || 15 degrees
 +
|-
 +
| Supine Position || 90 degrees
 +
|-
 +
| Reclined Position ||  at various degrees of tilt
 +
|}
  
 +
 +
 +
 +
 +
 +
''References:''
 +
::::1.  MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
 +
 +
 +
 +
 +
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<br>
 
<br>
  
===='''EEG Impedance Check using the Grass Impedance Meter 4.75'''====
+
===='''Chair Operation'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 943: Line 1,007:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''EEG Impedance Check using the Grass Impedance Meter'''<br>
+
'''Chair Operation'''<br>
'''Policy No. 4.75'''
+
'''Policy No. 5.40'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 9/03; 10/03; Revised: 6/06; 9/07; 10/08; 1/12; 1/15; 2/18'''<br>
+
'''Reviewed: 9/03; 10/03; Reviewed: 6/06; 10/08; 1/12; 1/15; Revised: 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 957: Line 1,021:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''When performing EEG, the electrode impedance will be checked using the Grass Impedance Meter to ensure adequate electrode contact with the scalp.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The MEG chair will be adjusted per standardized procedures in accordance with manufacturer's  specifications while optimizing recording standards and observing patient safety.'''
  
An external impedance check should be performed on all electrodes used for EEG, EOG or EMG using the Grass S88 Impedance Meter.  The Grass Impedance Meter measures AC impedance (resistance and capacitance).  When two or more electrodes are plugged into the electrode switch positions, all electrodes except the one selected electrode being measured are connected and provide the reference for the one being measured.
 
  
To perform an Impedance Check, at least two electrodes are required to be plugged in to the impedance meter.
+
'''Procedure:'''
  
'''Procedure:'''
+
::::::'''''Please Note: Chair Weight Limit - The MEG chair can accommodate subjects who weigh up to approximately 300 lbs.'''''
::::1.  The Electrode Selector Switch should be at position 1 - 10.
 
  
::::2Plug the ground electrode (Grd) into electrode jack 1 position.  
+
The MEG Chair Height can be raised and lowered for optimal positioning of the subject in the gantryThe chair is a pneumatic-hydraulic unit and there may be a 2-3 second delay when turning controls from the unlocked to the locked position or when making chair adjustments.  
  
::::3.  Plug the other electrode(s) into the jack positions 2 - 10 in a systematic manner.
+
*Turn the hand wheel and valves slowly when making any adjustments to allow the air pressure to equalize.
 +
 
 +
*The Chair Back Rest Tilt can be adjusted for various angles of reclined recording. And, the gantry angle can be adjusted for various angles of reclined recording, however, when the chair is in the upright position the gantry should be at 15 degrees.
 +
 
 +
*The operator should be completely familiar with the operation of the controls before operating the chair with a subject or patient’s head inside the gantry.
 +
 
 +
*There are two kinds of controls:
 +
::::-The <u>'''Hand Wheel'''</u> which controls the directions and rate of movement and
 +
::::-The <u>'''Valve Lock'''</u> controls which adjustment is selected or activated; it locks and unlocks the Back Rest and the Height controls.
  
::::4.  Press the Red ON Button to activate the impedance check.  *The power will automatically shutoff after approximately 2 minutes. (There is no OFF button.)
 
  
::::5.  If the impedance is too high:
 
:::::::a.  Take a cotton tip swab dipped in Nuprep (Abralyt or other skin prep) and twirl against the skin.
 
:::::::b.  Re-insert electrolyte.
 
:::::::c.  Re-measure impedance.
 
:::::::d.  Repeat this process until all impedances are within acceptable levels.
 
  
:::::::::::::::::::::'''Impedance Recommendations'''
+
::::'''1.  CHAIR BACKREST ADJUSTMENT'''
:::::::::::::::::::{| class="wikitable"
+
::::::The TILT Valve Lock - is located on the front panel of the armrest near the top, locks and unlocks the tilt function of the chair backrest.  
|-
 
| EEG Electrodes || 5-10K ohms
 
|-
 
| EMG Electrodes (EOG, ECG, etc.) || < 50K ohms
 
|}
 
  
::::6.  If the impedance exceeds 199.9K ohm, a “1” will appear in the left display window with all other digits blanked out indicating that the impedance is too high to be read:
+
::::::a.  Slowly turn the TILT Lock Valve to the unlocked position.   
:::::::a.  Take a cotton tip swab dipped in Nuprep (Abralyt or other skin prep) and twirl against the skin.
 
:::::::b.  Re-insert electrolyte.
 
:::::::cRe-measure impedance.
 
:::::::d.  Repeat this process until all impedances are within acceptable levels.
 
  
 +
::::::b.  Start in the upright position then adjust of necessary or requested by the subject. Position the backrest to provide the optimal level of neck and back alignment and comfort.
  
''Reference:''
+
::::::cWith the TILT Lock Valve in the UNLOCKED position the hand wheel controls the movement of the backrest / the backrest angle. Turn the hand wheel:
''1Grass EZM Electrode Impedance Meter Instructions Manual, Grass Instrument Division, Astro-Med, Inc.''
 
  
 +
::::::::::•  Clockwise to move the backrest forward.
 +
::::::::::•  Counter-clockwise for backward motions.
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
+
::::::d.  The Lock Valve should always be left in the LOCKED position unless adjustments are being made. 
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 
  
<br>
 
  
===<big>'''Magnetically Shielded Room (MSR) & Subject Support (5.00)'''</big>===
+
::::'''2. CHAIR HEIGHT ADJUSTMENT'''
 +
::::::The ELEVATION Lock Valve – located on the front panel of the armrest near the bottom, locks and unlocks the height function of the chair. 
  
==== '''Magnetically Shielded Room (MSR) 5.00''' ====
+
::::::a.  Slowly turn the Elevation Lock Valve to the unlocked position. * If this valve is released too fast the chair will “jump” in the direction last activated.
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
|style="width: 350px"|
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''Magnetically Shielded Room (MSR'''<br>
 
'''Policy No. 5.00'''
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Reviewed: 9/03; 10/03; Revised: 6/06; Reviewed: 9/07; 10/08; 1/12; 1/15; 2/18'''<br>
 
<br>
 
|-
 
|
 
'''Recommended By:'''<br>
 
'''MEG Core Facility Staff'''<br>
 
|
 
'''Distribution: MEG Core Facility'''
 
|-
 
|}
 
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Magnetically Shielded Room (MSR) will be utilized in accordance with manufacturer's recommendations and MEG Core guidelines.'''
 
  
 +
::::::b.  Position the subject so that his/her head is at or near the top of the dewar. Care should always be exercised when adjusting the chair height while a subject is seated under the gentry. *When trying to determine how close to the top of the Dewar the subject is positioned periodically ask the subject to raise himself/herself up in the dewar to determine how much room is remaining. Do not raise the chair while the subject is rising up in the chair. Ask the subject to relax back to whatever is comfortable for them, then adjust the chair to the subject.
  
'''I<u>MSR Room Lighting</u>'''
+
::::::cTurn the Hand Wheel:
::'''Turning on the lights in the MSR:'''
+
::::::::•  Clockwise to make the chair move upward.
::::*Depress the square green button on the VAC Power Supply Unit which is located on the bottom shelf of the equipment stand outside the MSR.
+
::::::::•  Counter-clockwise for downward motions.
::'''Dimming the lights in the MSR:'''
 
::::*Use the Brightness (black) knob to dim the light.
 
  
 +
::::::d.  Turn the Elevation Lock Valve to locked position unless adjustments are being made.
  
<br>
+
::::::eWhen lowering the chair leave at least 3 inches in the bellows.
'''II.  <u>MSR Door Operation</u>'''
 
::'''Closing the Door:'''
 
::::1.  Push the door up to the door frame as far as possible. 
 
::::2.  Press the OPEN/CLOSE BUTTON (Black Button) until the air locks activate and the door begins to close then quickly release the button to seal the door.
 
             
 
::'''Opening the Door:'''
 
::::1Press the OPEN/CLOSE BUTTON (Black Button) until the air locks release and the door begins to open then quickly release the button.
 
::::2.  Pull the door open.
 
  
::'''Door Emergency Operation:'''
 
::::1.  Emergency Door Open Button - If the door fails to open, press the EMERGENCY OFF BUTTON (red button) located on the wall outside of the MSR.  There is also an EMERGENCY OFF BUTTON located on the inside of the MSR door.
 
::::2.  Emergency Door Open Key - If the door fails to open when using the Emergency Off Button, then insert the EMERGENCY DOOR KEY in the upper and lower Emergency Unlock (yellow) keyholes and turn.  This will manually release the door locks.  Keys and keyholes are located on both sides of the MSR door.
 
  
  
<br>
+
::::'''3CHAIR MOVEMENT'''  
'''III<u>MSR Monitors</u>'''
+
::::::The BRAKE Lock Valve - is located on the side panel.  It locks and unlock the brakes for the chair’s back and forward movement on the (plexiglass) track.  The brake provides only a light braking effect.
::'''A.  Oxygen Monitor'''
+
 
::The Safetnet Oxygen Monitor which is mounted in the MEG Lab on the wall just outside the MSR measures the percentage of oxygen in the MEG lab which may be an indication of the air exchange in the MSR and/or the general integrity of the Dewar and related equipment.  Refer to Policy No. 10.15 Daily System Monitors / Quality Assurance.
+
::::::a.  Turn the valve to the UNLOCKED position.  While it is possible to move the chair with the brake in the LOCKED position this should be avoided as it will cause premature wear to the brake pad.
  
<br>
+
::::::bPhysically push the chair back so that the subject’s head is positioned directly under the gantry; the back of the head should at the back of the dewar. Two people are required to move the chair so that the chair glides evenly on the track and is not torqued to one side or the other which might damage or break the track.  Move the chair into position with one person pushing from each side of the chair.
::'''BHe Gas Flow Meter'''
 
::The Gilmont Gas Flow Meter is located inside the MSR mounted on the back left wall. It monitors the MEG Dewar helium level or rate of Helium boil off which gives an indication of the general integrity of the MEG Dewar and related equipment. Refer to Policy No. 10.15 Daily System Monitors / Quality Assurance.
 
  
<br>
+
::::::cAfter adjusting the chair set the Brake Valve to the LOCKED position to prevent movement of the chair.  
::'''CLiquid Helium Level'''
 
::The AMI Model 135 Liquid Helium Level Monitor which is located on the stand just outside the MSR measures the amount of helium inside the MEG Dewar. Refer to Policy No. 10.15 Daily System Monitors / Quality Assurance.
 
  
 +
::::::d.  When done recording, unlock the Brake Valve to move the chair forward to allow the subject to exit the chair without bumping their head on the Dewar or the Dewar arm.     
 +
                                                                                                                         
 +
::::::*Always check to make sure that cables are not on the track before moving the chair.
  
  
Line 1,067: Line 1,091:
  
 
'''''References:'''''
 
'''''References:'''''
::1.  VacuumSchmelze.
+
1.  MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
::2.  MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
 
  
  
Line 1,076: Line 1,099:
 
<br>
 
<br>
  
===='''Gantry Operation 5.20'''====
+
===='''Bed Operation'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 1,082: Line 1,105:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Gantry Operation'''<br>
+
'''Bed Operation'''<br>
'''Policy No. 5.20'''
+
'''Policy No. 5.60'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 9/03; 10/03; Reviewed: 6/06; 9/07; 10/08; 1/12; 1/15; Revised: 2/18'''<br>
+
'''Reviewed: 9/03; 10/03; Revised: 6/06; 9/07; 1/12; 1/15; 2/18; 8/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 1,096: Line 1,119:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The MEG Gantry will be used and maintained in accordance with manufacturer's specifications and MEG Core guidelines.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The MEG bed will be placed and adjusted per standardized procedures in accordance with manufacturer's specifications while optimizing recording standards and observing patient safety.'''
  
 +
'''Procedure:'''
  
+
::::1. Please note: The MEG bed can only accommodate subjects who weight up to 250 lbs.
There are two Gantry controls which are located on the side of the Gantry base: 1) the '''''Brake Lever''''' and, 2) the '''''Tilt Control Lever'''''. The Gantry controls have been designed so that the operator is required to use two hands to operate.  
+
::::2. Lower the Gantry to 90 degree tilt (horizontal position).  Gantry Controls are located on the right side of the base. The controls require the operator to use both hands to operate.  If either handle is released the gantry motion will stop.   
 
 
::::'''''Please note:'''''
 
::::::• The Brake Lever and the Tilt Control Lever must be engaged more-or-less at the same time.
 
 
 
::::::•  Pulling up on the '''<u>Brake Lever</u>''' turns on the power and releases the brake.   
 
  
:::::: Releasing the '''<u>Brake Lever</u>''' engages the lock and turns off the power.   
+
:::::a.  Raise the Brake Control Lever (lower / long handle).
 +
:::::b. Then raise the Direction Control Lever (upper / shorter handle).  This will release the brake.
 +
:::::c.  Then move the Direction Control Lever in the downward direction.
 +
:::::d.  Using the Angle Indicator readout located on the gantry near the front pivot point position, lower the gantry to 90 degrees.
 +
:::::e.  Release the Direction Control Lever to stop the motionRelease the Brake Control Lever.
  
::::::• The '''<u>Tilt Control Lever</u>''' is OFF when in the center position.
+
::::3. Lower the chair and slide the chair forward.
  
 +
::::4.  Recline the chair backrest to approximately a 45 degree tilt.
  
'''Procedure:'''
+
::::5.  Remove the arm rest from the chair. 
  
'''<u>To re-position / move the Gantry - lift the Brake Lever and hold it in the up position then:</u>'''
+
::::6.  The back cushion may be removed or left in place.
  
::1.  If raising the gantry,  
+
::::7.  If the top portion of the bed will have its angle adjusted, place the Roller Wheel Assembly and follow the steps below; if not skip to section 7.
  
::::a. While still holding the Brake Lever in the release (up) position, lift the Tilt Control Lever handle until the brake is released. You might hear a click or feel the pressure release. Maintain this position until the desired angle of tilt is reached.
+
::::::• If the chair back cushion has been left in place, first slide the backrest cushion to its lowest position.  
::::bAs the Tilt Control Lever handle is lifted further the gantry will begin to rise faster.
+
::::::•  Mount the Roller Wheel Assembly to the exposed seat back support plate*These steps are optional if the bed it is to be used in the flat/horizontal position.
::::c. When the angle of tilt is reached first release the Tilt Control Lever and then release the Brake Lever.  
+
 
+
:::::: If the head end cushion will have its angle adjusted, the cushion lock bolts should be removed from their locked position and stored in the holes I the blocks to which they are tied.
<br>
+
::::::•  The head end cushion of the bed can be adjusted in angles from horizontal to approx. 30 degrees using a link to the adjustable chair backrest.
::2. If lowering the gantry,
 
  
::::aWhile still holding the Brake Lever in the release (up) position, lift the Tilt Control Lever handle to raise the gantry up a few degrees until you hear the click or the Dewar begins to move in the upward direction. This action will release the brake then allow the gantry to lower.  
+
::::8Using two people, lift the bed by the ends using the hand grips which are mounted to the under side of the bed. *Lift the bed above the optical cables and any other sensitive equipment.
::::b.  Then push the Lever in the downward direction.  Pushing the Tilt Control Lever handle down will cause the gantry to lower.
 
 
 
<br>
 
::4.  Returning the Tilt Control Lever to the center “OFF” position will cause the gantry motion to slow to a stop.
 
  
<br>
+
::::9Set the bed onto the unpadded armrests of the chair. Align the holes on the bed frame with the holes on the pedestal.
::5Release the brake lever allowing it to go back to the horizontal position to turn off the power and engage / lock the brake.
 
  
 +
::::10.  Insert the four mounting bolts, which are tied to the base of the bed, through the holes in the bed base / pedestal.
  
 +
::::::a.  All four bolts should be screwed in a couple of turns and
 +
::::::b.  Fully tightened when all four are engaged.
  
 +
::::11.  Raise the bed so that it is level with the Dewar.
  
:::::::::::::::::::::::::'''Gantry Recording Positions'''
+
::::12. Slide the bed back so that it rests against the Dewar.
:::::::::::::::::::::::{| class="wikitable"
 
|-
 
| Sitting Position || 15 degrees
 
|-
 
| Supine Position || 90 degrees
 
|-
 
| Reclined Position || at various degrees of tilt
 
|}
 
  
  
 +
::::13. For subject safety one side rail must be in place before allowing a subject to get onto the bed; place the second rail after the subject has mounted the bed.
  
  
  
 
+
References:
''References:''
+
1.  MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com.)
::::1.  MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
 
  
  
 +
<br>
 +
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 +
<br>
  
 +
===<big>'''Stimulus / Response / Monitoring Equipment'''</big>===
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
+
==== '''Stimulus Computer''' ====
<br>
 
 
 
===='''Chair Operation 5.40'''====
 
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 1,167: Line 1,182:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Chair Operation'''<br>
+
'''Data Acquisition'''<br>
'''Policy No. 5.40'''
+
'''Policy No. 7.00'''
 
|style="width: 650px"|
 
|style="width: 650px"|
'''Date: 1/03 <br>
+
'''Date: 08/18 <br>
'''Reviewed: 9/03; 10/03; Reviewed: 6/06; 10/08; 1/12; 1/15; Revised: 2/18'''<br>
+
'''Revised: ; Reviewed: '''<br>
 +
 
 
<br>
 
<br>
 
|-
 
|-
Line 1,181: Line 1,197:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The MEG chair will be adjusted per standardized procedures in accordance with manufacturer's specifications while optimizing recording standards and observing patient safety.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Stimulus Computer will be utilized in accordance with manufacturer's recommendations and MEG Core guidelines.'''
 +
<br>
 +
'''Procedure:'''
 +
<br>
 +
:Please see MEG Core Facility Staff for training in the operation of the Stimulus computer. Users should not attempt to modify the stimulus computer in any way. If users need additional software, or a software upgrade, please inform MEG Core Facility Staff.
 +
<br>
 +
<div align="center">'''_____________________________________________________________________________'''</div>
 +
<br>
  
 +
===='''DLP Projector'''====
 +
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Propixx DLP Projector'''<br>
 +
'''Policy No. 6.00'''
 +
|style="width: 650px"|
 +
'''Date: 5/18 <br>
 +
<br>
 +
|-
 +
|
 +
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility'''
 +
|-
 +
|}
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Propixx DLP Projector will be utilized in accordance with manufacturer's specifications and MEG Core policies and procedures.'''
 +
<br>
 +
'''Procedure:'''
 +
<br>
 +
::The ProPixx DLP Back Projector system consists of a projector and a screen mounted to the gantry. Images are projected through a hole in the shielded room wall into a set of mirrors which projects the image onto the screen. 
  
:::::::::::'''''Please Note: Chair Weight Limit - The MEG chair can accommodate subjects who weight up to approximately 300 lbs.'''''
+
::::'''''Features:'''''
 +
::::-The image size is up to 40 degrees visual field for eye-screen distance of 37.2 to 52.5 cm.
 +
::::-a native resolution of 1920 x 1080 and can be driven with refresh rates up to 500Hz (RGB mode) or 1440 Hz (Greyscale mode) with deterministic timing.
 +
::::-Uses high brightness LEDs as a light source, giving a larger color gamut
 +
::::-The LEDs support high bit depth and high frequency full color stimulation.
 +
::::-TACHISTOSCOPC stimulation capability.
  
The MEG Chair Height can be raised and lowered for optimal positioning of the subject in the gantry. The chair is a pneumatic-hydraulic unit and there may be a 2-3 second delay when turning controls from the unlocked to the locked position or when making chair adjustments.  
+
::::'''''Equipped with:'''''
 +
::::-a complete digital I/O subsystem that synchronizes subject I/Os to video refresh with microsecond precision.
 +
::::-High-contrast white screen for precision color operation.
  
*Turn the hand wheel and valves slowly when making any adjustments to allow the air pressure to equalize.
 
  
*The Chair Back Rest Tilt can be adjusted for various angles of reclined recording. And, the gantry angle can be adjusted for various angles of reclined recording, however, when the chair is in the upright position the gantry should be at 15 degrees.
+
:'''I.  <u>Powering the Projector:</u>'''
 +
:''*The Projector has a 30-40 ms delay before it displays an image.''
  
*The operator should be completely familiar with the operation of the controls before operating the chair with a subject or patient’s head inside the gantry.
+
::::1. '''TO POWER ON''' - On the Propixx Projector, press the POWER BUTTON [[Image:Power_Button_picture.png|20px|Power Button]] once. ''*The power switch on the Controller Box should always be in the ON position.''
 +
 +
::::2. '''TO POWER OFF''' - press the POWER BUTTON [[Image:Power_Button_picture.png|20px|Power Button]] and hold for 3 seconds.  The projector will enter the thermal shutdown mode and after a short delay the power will turn off / enter the sleep mode.  *In order to preserve the bulb life, turn the projector "OFF" after each use.
  
*There are two kinds of controls:  
+
:::::::::{| class="wikitable"
::::-The <u>'''Hand Wheel'''</u> which controls the directions and rate of movement and
+
|-
::::-The <u>'''Valve Lock'''</u> controls which adjustment is selected or activated; it locks and unlocks the Back Rest and the Height controls.
+
! '''**CAUTION: Do NOT touch the POWER ON / OFF SWITCH**''' <br>'''''If you switch to the "OFF" position the projector will lose all programmed settings!'''''
 +
|-
 +
| [[Image:Power_Switch_picture.jpg|center|60px]]
 +
|}
  
  
Procedure:
 
  
::::'''1.  CHAIR BACKREST ADJUSTMENT'''
+
<br>
::::::The TILT Valve Lock - is located on the front panel of the armrest near the top, locks and unlocks the tilt function of the chair backrest.
 
  
::::::a. Slowly turn the TILT Lock Valve to the unlocked position.   
+
:'''II.  <u>Positioning the Projector:</u>'''
 +
::::The position of the projector does not need to be changed. For further information or help see MEG Staff.   
  
::::::b.  Start in the upright position then adjust of necessary or requested by the subject. Position the backrest to provide the optimal level of neck and back alignment and comfort.
+
<br>
  
::::::c.  With the TILT Lock Valve in the UNLOCKED position the hand wheel controls the movement of the backrest / the backrest angle. Turn the hand wheel:
+
:'''III.  <u>Lens Adjustments:</u>'''
 +
::::Manual Adjustment
 +
:::::To Focus - Turn the knurled ring (the silver and black lens collar) at the outer end of the lens to adjust the focus until the image is sharp. Generally, the focus should not have to be adjusted.
  
::::::::::•  Clockwise to move the backrest forward.
+
:::::To Zoom - Turn the smooth ring on the lens, closest to the case, to adjust the zoom so that the image fills the screen.
::::::::::•  Counter-clockwise for backward motions.
 
  
::::::d.  The Lock Valve should always be left in the LOCKED position unless adjustments are being made.
+
::::::::::'''''*The projector lens should be centered in the middle of the screen and should be perpendicular to the mirror; otherwise the image will be distorted, making viewing difficult.'''''
  
 +
<br>
  
::::'''2CHAIR HEIGHT ADJUSTMENT'''
+
:'''IV<u>Program Adjustment:</u>'''
::::::The ELEVATION Lock Valve – located on the front panel of the armrest near the bottom, locks and unlocks the height function of the chair.
+
::::All functions, like resolution, can be changed from the desktop of the stimulus computer. However, if changes are made, please change back to the default settings when done.
  
::::::a.  Slowly turn the Elevation Lock Valve to the unlocked position. * If this valve is released too fast the chair will “jump” in the direction last activated.
+
<br>
  
::::::b. Position the subject so that his/her head is at or near the top of the dewar. Care should always be exercised when adjusting the chair height while a subject is seated under the gentry. *When trying to determine how close to the top of the Dewar the subject is positioned periodically ask the subject to raise himself/herself up in the dewar to determine how much room is remaining. Do not raise the chair while the subject is rising up in the chair. Ask the subject to relax back to whatever is comfortable for them, then adjust the chair to the subject.
+
:'''V.  <u>The Remote Controller:</u>
 +
::::The Remote control has a 40 degree reception angle. The Remote must be pointed at the projector's LED  (which is located in the back left corner of the projector) within that 40 degree angle to be received.
  
::::::c.  Turn the Hand Wheel:
+
:::::*Using The Remote To Power The Projector On - Press POWER ON on the Remote Control to switch the projector ON.
::::::::•  Clockwise to make the chair move upward.
 
::::::::•  Counter-clockwise for downward motions.
 
  
::::::d.  Turn the Elevation Lock Valve to locked position unless adjustments are being made.  
+
:::::*Using The Remote To Power The Projector Off - Press POWER OFF on the Remote Control to switch the projector to OFF / SLEEP mode.
  
::::::e.  When lowering the chair leave at least 3 inches in the bellows.
+
:::::::::::::::::::'''''Please note: The LED ON / OFF button on the remote functions as the shutter on / off button.'''''
  
 +
<br>
  
 +
:'''VI.  <u>Projector Status Indicators:</u>'''
 +
::::The Projector's LEDs supply info on the power status and the energy status of the projector.
  
::::'''3.  CHAIR MOVEMENT'''
+
::::::::::{| class="wikitable"
::::::The BRAKE Lock Valve - is located on the side panel.  It locks and unlock the brakes for the chair’s back and forward movement on the (plexiglass) track.  The brake provides only a light braking effect.  
+
|-
 +
|•'''AWAKE MODE:''' ||<div align="center">''Press the POWER button and release, the projector will power ON.''<br>  
 +
'''''<u>The LED will be a solid BLUE light.</u>'''''<div>
 +
|-
  
::::::a.  Turn the valve to the UNLOCKED position.  While it is possible to move the chair with the brake in the LOCKED position this should be avoided as it will cause premature wear to the brake pad.
 
  
::::::b.  Physically push the chair back so that the subject’s head is positioned directly under the gantry; the back of the head should at the back of the dewar. Two people are required to move the chair so that the chair glides evenly on the track and is not torqued to one side or the other which might damage or break the track.  Move the chair into position with one person pushing from each side of the chair.
+
|•'''SLEEP MODE:'''  ||<div align="center">''Press the POWER button for 3 secs,'' <br>'''''<u>the LEDs will be a solid RED.</u>''''' <br>
 +
The projector will be in the sleep mode.
 +
|-
  
::::::c.  After adjusting the chair set the Brake Valve to the LOCKED position to prevent movement of the chair.   
 
  
::::::d. When done recording, unlock the Brake Valve to move the chair forward to allow the subject to exit the chair without bumping their head on the Dewar or the Dewar arm.      
+
|•'''THERMAL SHUTDOWN:'''  ||<div align="center">'''''<u>Flashing RED LEDs indicates the lamp is shutting down.</u>'''''<br>
                                                                                                                         
+
''When flashing stops, the projector is in the SLEEP Mode (OFF)'' <br> ''as indicated by the solid RED LEDs.''
::::::*Always check to make sure that cables are not on the track before moving the chair.
+
|}
  
  
 +
::VII. '''<u>Reversing The Projection Scheme For Supine Recording – To Be Determined</u>'''
 +
:::::a.  Press MENU.
 +
:::::b.  Use OPTION2 menu
 +
:::::c.  Select REAR projection- choose this option if pictures are projected from the rear of a reflective screen.
 +
:::::d.  Select CEILING mount – choose this option if the projector is installed on the ceiling (or upside down).
  
 
+
::VIII. '''<u>Mirror Adjustments</u>'''
'''''References:'''''
+
::::Wall Mirror Adjustments for Seated Recording:
1.  MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
+
:::::1.  Project an image onto the mirror.
 +
 
 +
:::::2.  Adjust the wall mirrors:
 +
:::::::a.  Position the top mirror in front of the lens so that the image is reflected down to the bottom mirror.
 +
 
 +
:::::::b.  Adjust the bottom mirror so that the image is projected centered onto the screen. 
 +
 
 +
::IX.  '''<u>Ceiling Mirror Adjustments for Supine Recording:</u>'''
 +
:::::1.  Place the ancillary wall mirror (smaller mirror) on the 2nd set of wall brackets.
 +
 
 +
:::::2.  Position the top mirror so that it projects onto the smaller mirror.  Position the smaller mirror so that it projects onto the ceiling mirror. 
 +
 
 +
:::::3.  Slide the ceiling mirror into position so that the image from the ceiling mirror is projected onto the screen.
 +
 
 +
 
 +
::X.  '''<u>Screen Adjustments</u>'''
 +
 
 +
:::::1. There are two possible viewing screens:
 +
:::::::a. The original screen with the original color pallet and,
 +
:::::::b. At white screen for high-resolution color. 
 +
 
 +
:::::2.  Position the screen so that the image is projected centered onto the screen. If possible, the screen should be perpendicular to the floor.
 +
 
 +
:::::3.  The screen distance can be increased or decreased by loosening the black knob located on the telescoping screen arm and adjusting the arm length.
 +
 
 +
:::::4If necessary, the screen can also be removed and flipped so that it is closer to the subject. Loosen the knob located on the telescoping screen arm.  Pull the arm out, flip the screen and re-insert.  Position the screen and tighten the knob.
 +
 
 +
:::::5.  Use the black knob located on the gantry mounting bar to raise and lower the screen.
 +
 
 +
:::::6. If you use the High-Resolution Screen please put the original screen back in place when done.
 +
<br>
 +
Reference:
 +
1. Propixx DLP Projector User Manual.  
  
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
  
 +
<div align="center">'''_____________________________________________________________________________'''</div>
  
 
<br>
 
<br>
  
===='''Bed Operation 5.60'''====
+
===='''Nerve / Muscle Stimulator'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 1,264: Line 1,366:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Bed Operation'''<br>
+
'''Nerve / Muscle Stimulator'''<br>
'''Policy No. 5.60'''
+
'''Policy No. 6.10'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 9/03; 10/03; Revised: 6/06; 9/07; 1/12; 1/15; 2/18'''<br>
+
'''Reviewed: 10/03; 8/06; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 1,278: Line 1,380:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The MEG bed will be placed and adjusted per standardized procedures in accordance with manufacturer's specifications while optimizing recording standards and observing patient safety.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Grass S88 Stimulator will be utilized in accordance with manufacturer's specifications and MEG Core policies and procedures.'''
 
 
 
 
'''''Please Note: Bed Weight Limit - The MEG bed can accommodate subjects who weight up to approximately 250 lbs. Before placing the bed, the chair must be at the lowest possible height. The arm rest must be removed and the chair back rest must be tilted to approximately 45-degrees.  The gantry must be tilted to 90 degrees. Two people must manually lift the bed and place it onto the chair pedestal. 
 
  
 +
<br>
 
'''Procedure:'''
 
'''Procedure:'''
 +
<br>
 +
<br>
 +
The Grass S88 Stimulator is a dual output general purpose stimulator intended for nerve and muscle stimulation procedures.  The two output channels can be operated independently or synchronized to produce complex paradigms.  The outputs are non-isolated constant voltage positive pulses.  Features include computer compatibility and flexibility of synchronization circuits: the synchronous inputs and outputs are TTL, 5 volts, PC compatible.  A rear DB25S connector permits external analog control of the timing circuits.  The Stimulus Isolation Unit (SIU) allows for applications requiring isolation and/or constant current.  Grass S88 Electrical Nerve/Muscle Stimulator - Stimulation is triggered via TTL outputs from the S88 to the MEG system electronics. 
 +
<br>
 +
::'''1. Power Switch'''
 +
::::a. The POWER toggle switch is flanked by the ON pilot lamp and the red overload lamp. 
  
::::1. Lower the Gantry to 90o tilt (horizontal position).  Gantry Controls are located on the right side of the base. The controls require the operator to use both hands to operate.  If either handle is released the gantry motion will stop. 
+
::::b. In the ON position, the pilot lamp will glow orange, indicating that line power is being supplied to the instrument.
 
 
::::::a.  Raise the Brake Control Lever (lower / long handle).
 
::::::b.  Then raise the Direction Control Lever (upper / shorter handle).  This will release the brake.
 
::::::c.  Then move the Direction Control Lever in the downward direction.
 
::::::d.  Using the Angle Indicator readout located on the gantry near the front pivot point position, lower the gantry to 90 degrees.
 
::::::e.  Release the Direction Control Lever to stop the motion.  Release the Brake Control Lever.
 
  
 +
::::c. The OVERLOAD lamp will glow red in the event of a short circuit at either output.  The circuit overload shuts off the HIGH VOLTAGE power supply. 
  
::::2. Lower the chair and slide the chair forward.
+
::::d. The red indicator lamp will remain ON until the POWER switch is turned OFF for a few seconds.
  
 +
::'''2. Stimulus ON-OFF-ON Lever Switch'''
 +
::::a. The STIMULUS ON-OFF-ON LEVER SWITCH is located at the right-hand corner of each channel.
  
::::3. Recline the chair backrest to approximately a 45 degree tilt.  
+
::::b. The upper ON position is for continuous voltage at the output; the lever switch will remain depressed (in the on position) when released; power will remain ON until the lever is switched to the up or off position.
  
 +
::::c. In the lower ON position the lever switch will remain ON only if it is depressed; it will return to the OFF position as soon as it is released.
  
::::4. Remove the arm rest from the chair.
+
::'''3. Stimulus Mode'''
 +
::The S88 FUNCTION can be set to deliver:
 +
::::a. Single – the RED SINGLE pushbutton is for manual operation (single independent pulses); also, delivers single repetitive stimulus.
 +
::::b. Repeat – repetitive stimulus; continuous presentation of a selected stimulus pattern (recurring pulses).
 +
::::c. Trains – trains per seconds (TPS) covers a range of 0.01 to 100 TPS; delivers a select number of pulses in defined intervals/delays.
 +
::::d. Twin Pulses – pulse per seconds (PPS); delivers two pulses of identical voltage and duration; the time between the onset of the first and second twin pulse is determined by the DELAY Circuit; twin pulses can be obtained singly, repetitively on in trains of pulses (can be used to determine nerve and muscle refractory times.
 +
::::e. Trains of Twin Pulses – delivers two pulses together in a series in defined intervals/delays from its single output.  
  
 +
::'''4. Controls'''
 +
::All controls are equal to the setting on the dial multiplied by the setting indicated on the decade (multiplier) switch.
 +
::::a. Rate – determines the rate at which pulses are delivered in pulses per second (1/100 sec to 100 PPS).
  
::::5. The back cushion may be removed or left in place.
+
::::b. Delay – length of time before the pulse starts; pre-pulse interval (10usec to 10 sec).
  
 +
::::c. Duration – pulse length; determines the length of time (T) in milliseconds that a pulse of a given frequency and voltage is delivered [1 msec to 10,000 msec (10 sec)].
  
::::6. If the top portion of the bed will have its angle adjusted, place the Roller Wheel Assembly and follow the steps below; if not skip to section 7.  
+
::::d. Volt Control - Controls the intensity / strength of the pulse; range at the output is from 0.01 to 150 volts.  Always begin with the VOLTS dial set to minimum (1) and increase until the desired stimulus intensity is achieved.
  
::::::•  If the chair back cushion has been left in place, first slide the backrest cushion to its lowest position.
+
::::e. Voltage Decade (multiplier) Switch- multiplier switch; the output impedance is also determined from the Volts Decade Switch.
::::::•  Mount the Roller Wheel Assembly to the exposed seat back support plate. *These steps are optional if the bed it is to be used in the flat/horizontal position.
 
 
::::::•  If the head end cushion will have its angle adjusted, the cushion lock bolts should be removed from their locked position and stored in the holes I the blocks to which they are tied. 
 
::::::•  The head end cushion of the bed can be adjusted in angles from horizontal to approx. 30 degrees using a link to the adjustable chair backrest.
 
  
 +
:::::i. In the first four positions, the output impedance is 250 ohms and is constant at these four positions:
 +
::::::a. X.01,
 +
::::::b. X.1,
 +
::::::c. X1 and
 +
::::::d. X10(SIU).
  
::::7. Using two people, lift the bed by the ends using the hand grips which are mounted to the under side of the bed. *Lift the bed above the optical cables and any other sensitive equipment.
+
:::::ii. At X10(25Ω) the output impedance is 25 ohms.
  
 +
:::::iii. For special applications requiring low impedance, high current output - set the multiplier to X10(25Ω).  This position is provided for use with low impedance electrodes to obtain a relatively high current out.  When using this mode, caution should be taken since very high stimulus currents can be delivered.
 +
::::::a. When a Stimulus Isolation Unit (SIU) is connected in series with the output the:
 +
::::::b.  X10(SIU) position is recommended for 15 to 150 volts out; *The SIU7 Isolation /Constant Current Unit should be operated at all times with the stimulator VOLTS multiplier set to the X10(SIU).
 +
::::::c.  X1 position is recommended for outputs of less than 15 volts. 
 +
 +
::::e. Train Rate – in the S2 TRAIN position, trains of stimulus patterns are presented at the output of S2 at the rate set by this control.
  
::::8. Set the bed onto the unpadded armrests of the chair. Align the holes on the bed frame with the holes on the pedestal.
+
::::f. Train Duration - in the S2 TRAIN position, trains of stimulus patterns are presented at the output of S2 at the duration set by this control.
  
 +
::::g. Train Mode – To obtain trains, this switch must be in the SINGLE or REPEAT position.
  
::::9.  Insert the four mounting bolts, which are tied to the base of the bed, through the holes in the bed base / pedestal.
+
:::::::{|class="wikitable"
 +
|+ Grass S88 Stimulator Specifications
 +
|Train Rate (S1 and S2) ||1/100 sec to 100 TPS (4 decades)
 +
|-
 +
|Train Duration ||1msec to 10 secs (4 decades)
 +
|-
 +
|Rate (S1 and S2) ||1/100 sec to 1000 PPS (5 decades)
 +
|-
 +
|Pulse Delay (S1 and S2) ||10usec to 10 secs (6 decades)
 +
|-
 +
|Pulse Duration (S1 and S2)||10usec to 10 secs (6 decades)
 +
|-
 +
|Synchronous Outputs (TTL)||S1, S2 S1 Delay, S2 Delay, Train
  
::::::a.  All four bolts should be screwed in a couple of turns and  
+
|-|Front Panel Output|| 10 usec, 50Ω
::::::b.  Fully tightened when all four are engaged.
+
|Rear Panel Outputs|| 1 or 10 msec and Train End
 +
|-
 +
|Synchronous Inputs (TTL)||Train Duration, S1 Delay, S2 Delay,
 +
|-
 +
|Trigger || Rising or Falling edge
 +
|-
 +
|Rear Connector (DB25S) || All SYNC INPUTS and OUTPUTS;
 +
|-
 +
|Volts Out (S1 and S2) ||10mV to 150V (4 decades)
 +
|-
 +
|Peak Output Current ||150mA with 1000Ω on highest range
 +
|-
 +
|Output Impedance ||250Ω nominal on all voltage ranges; 25Ω and 100kΩ on highest range
 +
|-
 +
|AC Power || 115/230V, 50/60Hz, 125 watts peak, 20 watts standby
 +
|-
 +
|Maximum power output ||22 watts
 +
|-
 +
|Current output ||150 milliamperes
 +
|-
 +
|Output Impedance || determined by the position of the VOLTS multiplier switch
 +
|-
 +
|Tolerance || All parameters are accurate to +5%
 +
|}
  
 +
::'''5. Additional Notes'''
 +
::::a. The output is a positive (with respect to chassis ground) non-isolated constant voltage square pulse. 
 +
::::b. The S88 cannot deliver a true symmetrical biphasic pulse which is equal in positive and negative amplitudes. However, if a Model Stimulus Isolation Unit (SIU)5 is used at either the S1 or S2 output, a biphasic waveform can be produced which, although not symmetrical, does have a negative and positive component which is equal in effective energy in terms of coulombs, if averaged over a sufficiently long period of time. 
 +
::::c. It is possible to obtain a true symmetrical biphasic pulse by mixing the output pulses from both S1 and S2 outputs through two Stimulus Isolation Units. Polarity can be changed only by connecting the S88 in series with an SIU and reversing polarity at the output of the SIU. 
 +
<br>
 +
Reference:
 +
1. Grass S88 Muscle / Nerve Stimulator Manual
  
::::10.  Raise the bed so that it is level with the Dewar.
 
  
 +
<div align="center">______________________________________________________________________________________________________________________________ </div>
 +
<br>
  
::::11.  Slide the bed back so that it rests against the Dewar.
+
===='''Auditory Stimulus System'''====
 
+
'''National Institute of Mental Health'''
 
+
{| class="wikitable"
*'''''Never operate the gantry while a subject’s head is in the helmet.'''''
+
|style="width: 350px"|
*'''''For subject safety one side rail must be in place before allowing a subject to get onto the bed; place the second rail after the subject has mounted the bed.'''''
+
'''Subject:'''<br>
 
 
 
 
 
 
References:
 
1.  MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com.)
 
 
 
 
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 
 
 
<br>
 
 
 
===<big>'''Stimulus / Response / Monitoring Equipment (6.00)'''</big>===
 
 
 
 
 
 
 
===='''DLP Projector 6.00'''====
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
|style="width: 350px"|
 
'''Subject:'''<br>
 
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Propixx DLP Projector'''<br>
+
'''Auditory Stimulus System'''<br>
'''Policy No. 6.00'''
+
'''Policy No. 6.20'''
 
|style="width: 650px"|
 
|style="width: 650px"|
'''Date: 5/18 <br>
+
'''Date: 1/03 <br>
 +
'''Reviewed: 10/03; Revised: 8/06; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 1,370: Line 1,515:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Propixx DLP Projector will be utilized in accordance with manufacturer's specifications and MEG Core policies and procedures.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Auditory Stimulation System will be used to deliver bilateral or unilateral tones at various decibels, frequencies, pitches and patterns as programmed or determined by the user or staff.'''
 +
<br>
 +
'''Procedure:'''
 +
<br>
 +
:The auditory stimulus is produced using Presentation or SoundBlaster software.  The interface includes: a Stereo amplifier, a pair of low-distortion silicone tubes which have about a 10 msec delay (due to the length of the tubing) and a bandwidth of 5 kHertz, foam ear inserts (in various sizes) to fit in the subject’s ear canal, and a sound level meter to calibrate sound delivered to the subject. Insertion depth affects interaural attenuation.  Be sure to select the correct size Foam Ear Tip to obtain the best fit in the ear canal.  Insert as far as possible into the ear canal.
  
<br>
+
:1. Attach the Foam Ear Tip Insert into the short Auditory Tubing Inserts. A connector (tube nibble) is required to keep the insert from coming out.
::The ProPixx DLP Back Projector system consists of a projector and a screen mounted to the gantry. Images are projected through a hole in the shielded room wall into a set of mirrors which projects the image onto the screen.
 
  
::::'''''Features:'''''
+
:2. Attach the short Auditory Tubing Inserts onto the end of the Low Distortion Silicone Auditory Tubes which are hanging on each side of the Gantry mounting bar. Place Red on the right side and the Blue on the left.
::::-The image size is up to 40 degrees visual field for eye-screen distance of 37.2 to 52.5 cm.
 
::::-a native resolution of 1920 x 1080 and can be driven with refresh rates up to 500Hz (RGB mode) or 1440 Hz (Greyscale mode) with deterministic timing.
 
::::-Uses high brightness LEDs as a light source, giving a larger color gamut
 
::::-The LEDs support high bit depth and high frequency full color stimulation.
 
::::-TACHISTOSCOPC stimulation capability.
 
  
::::'''''Equipped with:'''''
+
:3. Slowly roll (rather than squeeze) the Foam Ear Tip into so that they are as small as possible.
::::-a complete digital I/O subsystem that synchronizes subject I/Os to video refresh with microsecond precision.
 
::::-High-contrast white screen for precision color operation.
 
  
 +
:4. Quickly insert the compressed plug well into the ear canal.
  
:'''I. <u>Powering the Projector:</u>'''
+
:5. Hold in the ear with finger tip until expansion is complete.
:''*The Projector has a 30-40 ms delay before it displays an image.''
 
  
::::1. '''TO POWER ON''' - On the Propixx Projector, press the POWER BUTTON [[Image:Power_Button_picture.png|20px|Power Button]] once. ''*The power switch on the Controller Box should always be in the ON position.''
+
:6. Repeat process for the remaining ear.
+
                                                                                                                     
::::2. '''TO POWER OFF''' - press the POWER BUTTON [[Image:Power_Button_picture.png|20px|Power Button]] and hold for 3 seconds.  The projector will enter the thermal shutdown mode and after a short delay the power will turn off / enter the sleep mode*In order to preserve the bulb life, turn the projector "OFF" after each use.
+
:7. The tubing may be taped to the ear or on the subject’s cheek to assure that the insert does not become dislodged during testing.
 +
 
 +
:8. Click on Presentation or SoundBlaster software from the desktop on the Stimulus Computer located at the operator’s console.
 +
 
 +
:9. Test to make sure that the equipment is working properly and to assure that the sounds are being delivered to both left and right ears.   
 +
 
 +
:10. Adjust the sound intensity to the desired level (dB).
  
:::::::::::::{| class="wikitable"
+
:::::::::::{| class="wikitable"  
 +
|-
 +
! How To Place Foam Ear Tip Inserts <br>For A Secure & Comfortable Fit
 +
|-
 +
| 1.  Roll the tube really tight (usually better if you use both hands).
 +
|-
 +
| 2.  Figure out how the tube should go in the ear canal first by determining <br>the angle of the ear canal.  Generally, the ear canal goes up at an angle.
 +
|-
 +
| 3.  Pull the ear out and up to open up the canal.
 +
|-
 +
| 4.  Then gently push the tube in so that it is situated behind the tragus.
 
|-
 
|-
! '''**CAUTION: Do NOT touch the POWER ON / OFF SWITCH**''' <br>'''''If you switch to the "OFF" position the projector will lose all programmed settings!'''''
+
| 5.  Hold the tube in place for several seconds to allow the tube to expand in the ear canal. <br>*If you do not hold the tube in place while it expands it is possible that it might be push out <br>of the ear canal while expanding.
 
|-
 
|-
| [[Image:Power_Switch_picture.jpg|center|60px]]
+
| Note: if the tube does not go or fit in the ear canal do not force it in; take the tube back out and re-roll;<br> if it still does not fit, use a smaller size.
 
|}
 
|}
  
 
+
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
 
 
<br>
 
<br>
  
:'''II.  <u>Positioning the Projector:</u>'''
+
===='''Eye Tracking System'''====
::::The  position of the projector does not need to be changed. For further information or help see MEG Staff. 
+
'''National Institute of Mental Health'''
 
+
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Eye Tracking System'''<br>
 +
'''Policy No. 6.30'''
 +
|style="width: 650px"|
 +
'''Date: 1/03 <br>
 +
'''Revised: 1/12; 1/15; Revised: 2/18'''<br>
 
<br>
 
<br>
 +
|-
 +
|
 +
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility'''
 +
|-
 +
|}
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Infrared Eye Position Tracking System will be used to track eye position or fixation when needed during MEG recording.'''
  
:'''III.  <u>Lens Adjustments:</u>'''
 
::::Manual Adjustment
 
:::::To Focus - Turn the knurled ring (the silver and black lens collar) at the outer end of the lens to adjust the focus until the image is sharp. Generally, the focus should not have to be adjusted.
 
 
:::::To Zoom - Turn the smooth ring on the lens, closest to the case, to adjust the zoom so that the image fills the screen.
 
 
::::::::::'''''*The projector lens should be centered in the middle of the screen and should be perpendicular to the mirror; otherwise the image will be distorted, making viewing difficult.'''''
 
 
 
<br>
 
<br>
 +
'''Procedure:'''
 +
<br>
 +
:The Infrared Eye Position Tracking System – The infra-red eye tracking system captures a zoomed in video of the subject’s eye after calibration, and can estimate gaze position onto a screen providing gaze coordinates and pupil dilation.  Gaze position can then be broadcast to the stimulus and/or ACQ computer for real-time or post-hoc analysis.
 +
 +
<br>
 +
:The Infrared Eye Position Tracking System includes the: '''
  
:'''IV<u>Program Adjustment:</u>'''
+
::1Infrared Camera (located in the MSR).
::::All functions, like resolution, can be changed from the desktop of the stimulus computer. However, if changes are made, please change back to the default settings when done.
+
::2.  Infrared Light
 +
::3.  Eye Tracking Computer
 +
::4. Eye Tracking Software
  
<br>
 
  
:'''V. <u>The Remote Controller:</u>
+
<div align="center">'''''*See MEG Core staff for setup.'''''</div>
::::The Remote control has a 40 degree reception angle. The Remote must be pointed at the projector's LED  (which is located in the back left corner of the projector) within that 40 degree angle to be received.
 
  
:::::*Using The Remote To Power The Projector On - Press POWER ON on the Remote Control to switch the projector ON.
 
  
:::::*Using The Remote To Power The Projector Off - Press POWER OFF on the Remote Control to switch the projector to OFF / SLEEP mode.
 
 
:::::::::::::::::::'''''Please note: The LED ON / OFF button on the remote functions as the shutter on / off button.'''''
 
  
 +
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<br>
 
<br>
  
:'''VI.  <u>Projector Status Indicators:</u>'''
+
===='''Response Devices'''====
::::The Projector's LEDs supply info on the power status and the energy status of the projector.
+
'''National Institute of Mental Health'''
 
+
{| class="wikitable"
::::::::::::::{| class="wikitable"
+
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Response Devices'''<br>
 +
'''Policy No. 6.40'''
 +
|style="width: 650px"|
 +
'''Date: 1/03 <br>
 +
'''Reviewed: 10/03; Revised: 8/06; 11/08; 1/12; 1/15; 2/18'''<br>
 +
<br>
 
|-
 
|-
|'''AWAKE MODE:''' ||<div align="center">''Press the POWER button and release, the projector will power ON.''<br>
+
|  
'''''<u>The LED will be a solid BLUE light.</u>'''''<div>
+
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility'''
 
|-
 
|-
 +
|}
  
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The various response systems will provide for subject response monitoring via an electronics interface which will output to the acquisition computer to observe or examine response input and / or response time.'''
  
|•'''SLEEP MODE:'''  ||<div align="center">''Press the POWER button for 3 secs,'' <br>'''''<u>the LEDs will be a solid RED.</u>''''' <br>
 
The projector will be in the sleep mode.
 
|-
 
  
 +
'''Procedure:'''
  
|•'''THERMAL SHUTDOWN:'''  ||<div align="center">'''''<u>Flashing RED LEDs indicates the lamp is shutting down.</u>'''''<br>
+
::'''I. Lumitouch Response Pad'''
''When flashing stops, the projector is in the SLEEP Mode (OFF)'' <br> ''as indicated by the solid RED LEDs.''
+
::The Lumitouch is a fiber optic response keypad where there are five response buttons arranged in a row to correspond to the thumb and the fingers.  The response keypads and cabling are fabricated from 100% plastic materials and therefore do not cause electromagnetic interference. The fiber-optic cables run from the pads through a wave guide to a controller box which is connected to the stimulus PC via a USB cable.
|}
 
  
 +
::::1.  Place the response pad on the left or right arm rest.
  
::VII. '''<u>Reversing The Projection Scheme For Supine Recording – To Be Determined</u>'''
+
::::2Arrange fingers so that all or a subset of fingers can be used in natural
:::::aPress MENU.
+
::::order and positioning when responding to visual and/or auditory stimuli.
:::::b.  Use OPTION2 menu
 
:::::c.  Select REAR projection- choose this option if pictures are projected from the rear of a reflective screen.
 
:::::d.  Select CEILING mount – choose this option if the projector is installed on the ceiling (or upside down).
 
  
::VIII. '''<u>Mirror Adjustments</u>'''
+
::::3Place the cables so that they are not on the MEG chair’s track when the chair is being moved.
::::Wall Mirror Adjustments for Seated Recording:
 
:::::1Project an image onto the mirror.
 
  
:::::2Adjust the wall mirrors:
+
::::4Instruct the subject in the use of the Lumitouch Response Keypad for the research study task.
:::::::a.  Position the top mirror in front of the lens so that the image is reflected down to the bottom mirror.
 
  
:::::::bAdjust the bottom mirror so that the image is projected centered onto the screen.
+
<br>
 +
::'''II.  FORP Response Pad'''
 +
::The FORP is a Fiber-Optic Response Pad (FORP) where the 4 keys arranged in a diamond pattern.  There are 4 colored buttons which are arranged in a diamond pattern: Blue=1, Yellow=2, Green=3, Red=4The response keypads and cabling are fabricated from 10% plastic materials and therefore do not cause electromagnetic interference. The fiber-optic cables run from the pads through a wave guide to a controller box which is connected to the stimulus PC via a USB cable.
  
::IX.  '''<u>Ceiling Mirror Adjustments for Supine Recording:</u>'''
+
::::1.  Instruct the subject to hold or cup the response pad in the dominant or non-dominant hand while using the thumb to respond to the appropriate color, position, number or pattern. Position the pad so that the cable is in the superior orientation.
:::::1.  Place the ancillary wall mirror (smaller mirror) on the 2nd set of wall brackets.  
 
  
:::::2.  Position the top mirror so that it projects onto the smaller mirror.  Position the smaller mirror so that it projects onto the ceiling mirror.
+
::::2.  Place the cables so that they are not on the MEG chair’s track when the chair is being moved.
  
:::::3.  Slide the ceiling mirror into position so that the image from the ceiling mirror is projected onto the screen.
+
::::3.  Instruct the subject in the use of the FORP Response Pad for the research study task.
  
 +
<br>
 +
::'''III.  Joy Stick Control'''
 +
::The Joy Stick is a manual input device with a moveable control lever that can be tilted in various directions to control pointing devices or on-screen objects used for graphic applications.'''
  
::X'''<u>Screen Adjustments – There are two screens:</u>'''
+
::::1Instruct the subject to grasp the joystick control lever.
:::::::a) the original screen with the original color pallet and,
 
:::::::b) a white screen for high-resolution color.
 
  
:::::1Position the screen so that the image is projected centered onto the screen. If possible, the screen should be perpendicular to the floor.
+
::::2Place the cables so that they are not on the MEG chair’s track when the chair is being moved.
  
:::::2The screen distance can be increased or decreased by loosening the black knob located on the telescoping screen arm and adjusting the arm length.  
+
::::3Instruct the subject in the use of the joystick for the research study task.
  
:::::3.  If necessary, the screen can also be removed and flipped so that it is closer to the subject. Loosen the knob located on the telescoping screen arm.  Pull the arm out, flip the screen and re-insert.  Position the screen and tighten the knob.
+
<br>
 +
::'''IV.  Motion Detector'''
 +
::'''The laser Motion Detector is a device that contains a physical mechanism or electronic sensor that quantifies movement which is integrated with or connected to other devices that alert the user of the presence of a moving object within the field of view.
  
:::::4.  Use the black knob located on the gantry mounting bar to raise and lower the screen.
+
<br>
 +
::'''V.  Optical Microphone'''
 +
::An Optical Microphone is an acoustic-to-electric transducer or sensor that converts sound into an electrical signal.
  
::::::::::::::::::::'''''*If you use the <u>High-Resolution Screen</u> please put the original screen back in place when done.'''''
+
<br>
 +
::'''VI.  Pneumatic Air Pressure Device'''
 +
::The Pneumatic Air Pressure Device is attached to the pressure response ball which the subject squeezes to indicate a response. The unit can be calibrated for a gradated response or the thresholds can be set to give an on / off response.
  
  
 
+
<div align="center">______________________________________________________________________________________________________________________________ </div>
Reference:
 
1. Propixx DLP Projector User Manual.
 
 
 
 
 
 
 
<div align="center">'''_____________________________________________________________________________'''</div>
 
 
 
 
<br>
 
<br>
  
===='''Nerve / Muscle Stimulator 6.10'''====
+
===='''Stimulus Devices'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 1,510: Line 1,684:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Nerve / Muscle Stimulator'''<br>
+
'''Stimulation Devices'''<br>
'''Policy No. 6.10'''
+
'''Policy No. 6.45'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 10/03; 8/06; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
+
'''Reviewed: 10/03; Revised: 8/06; 11/08; 1/12; 1/15; 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 1,524: Line 1,698:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Grass S88 Stimulator will be utilized in accordance with manufacturer's specifications and MEG Core policies and procedures.'''
 
  
The Grass S88 Stimulator is a dual output general purpose stimulator intended for nerve and muscle stimulation procedures.  The two output channels can be operated independently or synchronized to produce complex paradigms.  The outputs are non-isolated constant voltage positive pulses.  Features include computer compatibility and flexibility of synchronization circuits: the synchronous inputs and outputs are TTL, 5 volts, PC compatible.  A rear DB25S connector permits external analog control of the timing circuits.  The Stimulus Isolation Unit (SIU) allows for applications requiring isolation and/or constant current.  Grass S88 Electrical Nerve/Muscle Stimulator - Stimulation is triggered via TTL outputs from the S88 to the MEG system electronics.
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The various stimulation devices provide for subject stimulation via an electronics interface which will output to the acquisition computer to observe or examine <br>response input, subject reaction and / or response time.'''
  
Procedure:
+
'''Procedure:'''
1. Power Switch
 
a. The POWER toggle switch is flanked by the ON pilot lamp and the red overload lamp. 
 
  
b. In the ON position, the pilot lamp will glow orange, indicating that line power is being supplied to the instrument.
+
::'''I. Air Puff Stimulator'''
 +
::The Air Puff Stimulator is a tactile sensory nerve stimulator. The Air-puff stimulator is applied to the fingertip.  It produces a puff of air which provides tactile stimulation that produces a measurable sensory response in the nerve and sensorimotor cortex.
  
c. The OVERLOAD lamp will glow red in the event of a short circuit at either output.  The circuit overload shuts off the HIGH VOLTAGE power supply.
+
::'''II. LED Flasher'''
 +
::The LED Flasher is a light emitting diode which flashes a red strobe light for visual system stimulation.
  
d. The red indicator lamp will remain ON until the POWER switch is turned OFF for a few seconds.
+
::'''III. Piezo Buzzer'''
 +
::A buzzer device which has no moving parts which uses the electromechanical interaction between the mechanical and the electrical state in a crystalline material to measure pressure, acceleration, strain or force and converts them to an electrical charge.  
  
  
  
2. Stimulus ON-OFF-ON Lever Switch
+
<div align="center">______________________________________________________________________________________________________________________________ </div>
a. The STIMULUS ON-OFF-ON LEVER SWITCH is located at the right-hand corner of each channel.
+
<br>
  
b. The upper ON position is for continuous voltage at the output; the lever switch will remain depressed (in the on position) when released; power will remain ON until the lever is switched to the up or off position.
+
===='''Voice Intercom System'''====
 +
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Voice Intercom System'''<br>
 +
'''Policy No. 6.70'''
 +
|style="width: 650px"|
 +
'''Date: 11/03 <br>
 +
'''Reviewed: 8/06; 11/08; Revised: 1/12; 1/15; 2/18'''<br>
 +
<br>
 +
|-
 +
|
 +
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility'''
 +
|-
 +
|}
  
c. In the lower ON position the lever switch will remain ON only if it is depressed; it will return to the OFF position as soon as it is released.
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Voice Intercom System will be used to facilitate communications with subjects while inside the Magnetically Shielded Room (MSR).'''
  
 +
'''Procedure:'''
 +
<br>
 +
::'''I. The Voice Intercom System consists of:'''
 +
::::1. The Intercom Electronics Box - located at the acquisition workstation / operator’s console. The Intercom Electronics Box allows the MEG operator to adjust the volume level at the console and the volume level inside the MSR independently. When at the Acquisition Console, the MEG operator can communicate with the subject inside the MSR through this device. This system works like a Walkie-Talkie, that is, when the operator is talking (depressing the “talk” button he/she cannot hear the subject and when he/she releases the button he/she can hear the subject speaking).
  
-1-
+
::::2. Parabolic Microphone - located inside the MSR. It is used to pick up and amplify the subject’s voice so that it can be heard at the operator’s console in order to facilitate communication between the subject and the operator.
   
 
MEG Core Facility                                                     Grass S88 Nerve/Muscle Stimulator
 
Procedures Manual                                                                                                                      Policy No. 6.10
 
-2-
 
  
3. Stimulus Mode
+
::::3. Flat Speaker - located inside the MSR. It is used to pick up and amplify the operator’s voice so that it can be heard by the subject inside the MSR.
The S88 FUNCTION can be set to deliver:
 
a. Single – the RED SINGLE pushbutton is for manual operation (single independent pulses); also, delivers single repetitive stimulus.
 
b. Repeat – repetitive stimulus; continuous presentation of a selected stimulus pattern (recurring pulses).
 
c. Trains – trains per seconds (TPS) covers a range of 0.01 to 100 TPS; delivers a select number of pulses in defined intervals/delays.
 
d. Twin Pulses – pulse per seconds (PPS); delivers two pulses of identical voltage and duration; the time between the onset of the first and second twin pulse is determined by the DELAY Circuit; twin pulses can be obtained singly, repetitively on in trains of pulses (can be used to determine nerve and muscle refractory times.
 
e. Trains of Twin Pulses – delivers two pulses together in a series in defined intervals/delays from its single output.  
 
  
 +
::::4. There are no intercom controls inside the MSR.
 +
<br>
 +
::'''II. Operation:'''
 +
::::1.  Press the Red power button to turn ON the Intercom Electronics Box.
  
4. Controls
+
::::2. Press the PUSH TO TALK button located on the front of the Intercom Electronics Box to speak to a subject inside the MSR.  
All controls are equal to the setting on the dial multiplied by the setting indicated on the decade (multiplier) switch.
 
a. Rate – determines the rate at which pulses are delivered in pulses per second (1/100 sec to 100 PPS).
 
  
b. Delay – length of time before the pulse starts; pre-pulse interval (10usec to 10 sec).
+
::::3. Release the button to hear the subject speak.
  
c. Duration – pulse length; determines the length of time (T) in milliseconds that a pulse of a given frequency and voltage is delivered [1 msec to 10,000 msec (10 sec)].  
+
::::4. Adjust the volume inside the MSR, so that the subject inside the MSR can hear the operator, using the knob labelled “MSR” located on the Intercom Electronics Box.
  
d. Volt Control - Controls the intensity / strength of the pulse; range at the output is from 0.01 to 150 volts.  Always begin with the VOLTS dial set to minimum (1) and increase until the desired stimulus intensity is achieved.
+
::::5. Adjust the volume at the Acquisition Workstation / Operator’s Console, so that the operator at the console can hear the subject, using the knob labelled “Console” on the Intercom Electronics Box.
  
e. Voltage Decade (multiplier) Switch- multiplier switch; the output impedance is also determined from the Volts Decade Switch.
 
  
• In the first four positions, the output impedance is 250 ohms and is constant at these four positions:
 
i. X.01,
 
ii. X.1,
 
iii. X1 and
 
iv. X10(SIU).
 
  
• At X10(25Ω) the output impedance is 25 ohms.
 
  
• For special applications requiring low impedance, high current output - set the multiplier to X10(25Ω). This position is provided for use with low impedance electrodes to obtain a relatively high current out. When using this mode, caution should be taken since very high stimulus currents can be delivered.  
+
Reference:
 +
::1.  MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
  
• When a Stimulus Isolation Unit (SIU) is connected in series with the output the:
 
  
i.  X10(SIU) position is recommended for 15 to 150 volts out; *The SIU7
 
                        Isolation /Constant Current Unit should be operated at all times with the
 
                        stimulator VOLTS multiplier set to the X10(SIU).
 
  
            ii.  X1 position is recommended for outputs of less than 15 volts. 
 
 
MEG Core Facility                                                     Grass S88 Nerve/Muscle Stimulator
 
Procedures Manual                                                                                                                      Policy No. 6.10
 
-3-
 
  
  
f. Train Rate – in the S2 TRAIN position, trains of stimulus patterns are presented at the output of S2 at the rate set by this control.
+
<div align="center">______________________________________________________________________________________________________________________________ </div>
 +
<br>
  
g. Train Duration - in the S2 TRAIN position, trains of stimulus patterns are presented at the output of S2 at the duration set by this control.
+
===='''Video Display Monitor'''====
 
+
'''National Institute of Mental Health'''
h. Train Mode – To obtain trains, this switch must be in the SINGLE or REPEAT position.
+
{| class="wikitable"
 
+
|style="width: 350px"|
Grass S88 Stimulator Specifications
+
'''Subject:'''<br>
Train Rate (S1 and S2) 1/100 sec to 100 TPS (4 decades)
+
'''MEG Core Facility'''<br>
Train Duration 1msec to 10 secs (4 decades)
+
'''Video Display Monitor'''<br>
Rate (S1 and S2) 1/100 sec to 1000 PPS (5 decades)
+
'''Policy No. 6.80'''
Pulse Delay (S1 and S2) 10usec to 10 secs (6 decades)
 
Pulse Duration (S1 and S2) 10usec to 10 secs (6 decades)
 
Synchronous Outputs (TTL) S1, S2 S1 Delay, S2 Delay, Train; Front Panel: 10 usec, 50Ω
 
Rear Panel: 1 or 10 msec and Train End
 
Synchronous Inputs (TTL) Train Duration, S1 Delay, S2 Delay,
 
Trigger from rising or falling edge
 
Rear Connector (DB25S) All SYNC INPUTS and OUTPUTS;
 
External Analog Timing Control
 
Volts Out (S1 and S2) 10mV to 150V (4 decades)
 
Peak Output Current 150mA with 1000Ω on highest range
 
Output Impedance 250Ω nominal on all voltage ranges
 
25Ω and 100kΩ on highest range
 
AC Power 115/230V, 50/60Hz,
 
125 watts peak, 20 watts standby
 
 
The maximum power output is 22 watts.
 
Current out is 150 milliamperes with a 1000-ohm load.
 
Output Impedance is determined by the position of the VOLTS multiplier switch.
 
All parameters are accurate to +5%.
 
 
 
• The output is a positive (with respect to chassis ground) non-isolated constant voltage square pulse. 
 
• The S88 cannot deliver a true symmetrical biphasic pulse which is equal in positive and negative amplitudes.
 
• However, if a Model Stimulus Isolation Unit (SIU)5 is used at either the S1 or S2 output, a biphasic waveform can be produced which, although not symmetrical, does have a negative and positive component which is equal in effective energy in terms of coulombs, if averaged over a sufficiently long period of time. 
 
• It is possible to obtain a true symmetrical biphasic pulse by mixing the output pulses from both S1 and S2 outputs through two Stimulus Isolation Units. Polarity can be changed only by connecting the S88 in series with an SIU and reversing polarity at the output of the SIU. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Reference:
 
1. Grass S88 Muscle / Nerve Stimulator Manual
 
 
 
 
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
 
 
 
 
 
 
<br>
 
 
 
===='''Auditory Stimulus System 6.20'''====
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
|style="width: 350px"|
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''Auditory Stimulus System'''<br>
 
'''Policy No. 6.20'''
 
 
|style="width: 650px"|
 
|style="width: 650px"|
'''Date: 1/03 <br>
+
'''Date: 11/03 <br>
'''Reviewed: 10/03; Revised: 8/06; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
+
'''Reviewed: 8/06; 11/08; Revised: 1/12; 1/15; 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 1,674: Line 1,795:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Auditory Stimulation System will be used to deliver bilateral or unilateral tones at various decibels, frequencies, pitches and patterns as programmed or <br>determined by the user or staff.'''
 
 
  
'''The auditory stimulus is produced using Presentation or SoundBlaster software. The interface includes: a Stereo amplifier, a pair of low-distortion silicone tubes which have <br>about a 10 msec delay (due to the length of the tubing) and a bandwidth of 5kHertz, foam ear inserts (in various sizes) to fit in the subject’s ear canal, and a sound level meter <br>to calibrate sound delivered to the subject.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Video Display Monitor will be used to monitor subjects inside the MSR.'''
  
+
<br>
 
'''Procedure:'''
 
'''Procedure:'''
 +
<br>
 +
::::::::::::'''*Always monitor subjects via the Video Display Monitor when running a study.'''
  
1.  Attach the Foam Ear Tip Insert into the short Auditory Tubing Inserts. A connector (tube nibble) is required to keep the insert from coming out.
+
:::::::::::::'''''THE SUBJECT MUST BE OBSERVED AT ALL TIMES DURING TESTING.'''''
  
2. Attach the short Auditory Tubing Inserts onto the end of the Low Distortion Silicone Auditory Tubes which are hanging on each side of the Gantry mounting bar. <br>
+
::The Video Display Monitor which is located at the acquisition workstation / operator’s console is used to monitor subjects inside the MSR. MEG users will observe the subject at all times while inside the MSR. There are currently two channels / two cameras in use for subject observation. Each camera is located or mounted at a different angle. Select the camera angle that is best for viewing the subject and any related equipment.
:Place Red on the right side and the Blue on the left.
+
::a.  To turn the monitor on - press the ON/OFF switch located on the front panel of the Video Display Monitor.  
  
3Slowly roll (rather than squeeze) the Foam Ear Tip into so that they are as small as possible.
+
::bPress the channel button once to access the next channel.
  
4Quickly insert the compressed plug well into the ear canal.  
+
::cContinue to press the channel button to access the other channels.
  
5.  Hold in the ear with finger tip until expansion is complete.
+
::::::::::::::{| class="wikitable"
 
 
6.  Repeat process for the remaining ear.
 
                                                                                                                     
 
7.  The tubing may be taped to the ear or on the subject’s cheek to assure that <br>
 
:the insert does not become dislodged during testing.
 
 
 
8.  Click on Presentation or SoundBlaster software from the desktop on the Stimulus Computer located at the operator’s console.
 
 
 
9.  Test to make sure that the equipment is working properly and to assure that the sounds <br>
 
:are being delivered to both left and right ears. 
 
 
 
10. Adjust the sound intensity to the desired level (db).
 
 
 
 
 
:::::::::::::::::::{| class="wikitable"  
 
 
|-
 
|-
! How To Place Foam Ear Tip Inserts <br>For A Secure & Comfortable Fit
+
| '''Channel 1''' || Camera 1 (Infrared Camera)
 
|-
 
|-
| 1.  Roll the tube really tight (usually better if you use both hands).
+
| '''Channel 2''' || Camera 2 (Color Camera)
|-
 
| 2.  Figure out how the tube should go in the ear canal first by determining <br>the angle of the ear canal.  Generally, the ear canal goes up at an angle.
 
|-
 
| 3.  Pull the ear out and up to open up the canal.
 
|-
 
| 4.  Then gently push the tube in so that it is situated behind the tragus.
 
|-
 
| 5.  Hold the tube in place for several seconds to allow the tube to expand in the ear canal. <br>*If you do not hold the tube in place while it expands it is possible that it might be push out <br>of the ear canal while expanding.
 
|-
 
| Note:  if the tube does not go or fit in the ear canal do not force it in; take the tube back out and re-roll;<br> if it still does not fit, use a smaller size.
 
 
|}
 
|}
 
+
                 
<div align="center">'''''*Insertion depth affects interaural attenuation.  Be sure to select the correct size Foam Ear Tip to</div> <br><div align="center">obtain the best fit in the ear canal.  Insert as far as possible into the ear canal.'''''</div>
 
 
 
 
 
Reference:
 
::1.  Auditory Tubing User Instructions.
 
 
 
 
 
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<br>
 
<br>
  
===='''Eye Tracking System 6.30'''====
+
===='''Infrared Lighting'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 1,739: Line 1,828:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Eye Tracking System'''<br>
+
'''Infrared Lighting'''<br>
'''Policy No. 6.30'''
+
'''Policy No. 6.90'''
 
|style="width: 650px"|
 
|style="width: 650px"|
'''Date: 1/03 <br>
+
'''Date: 11/03 <br>
'''Revised: 1/12; 1/15; Revised: 2/18'''<br>
+
'''Reviewed: 8/06; 11/08; Revised: 1/12; 1/15; 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 1,753: Line 1,842:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Infrared Eye Position Tracking System will be used to track eye position or fixation when needed during MEG recording.'''
 
  
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Infrared Light will be utilized in accordance with the manufacturer’s guidelines and MEG Core Facility policies and procedures.'''
 
<br>
 
<br>
'''The Infrared Eye Position Tracking System – The infra-red eye tracking system captures a zoomed in video of the subject’s eye after calibration, and can estimate <br>gaze position onto a screen providing gaze coordinates and pupil dilation.  Gaze position can then be broadcast to the stimulus and/or ACQ computer for <br>real-time or post-hoc analysis.'''
 
 
<br>
 
'''The Infrared Eye Position Tracking System includes the: '''
 
  
::1. Infrared Camera (located in the MSR).
+
''''Procedure:'''
::2.  Infrared Light  
+
::1. The Infrared Light illuminates the inside of the MSR when recording in a dark environment so that the subject may be seen via the Video Display Monitor. The Infrared Light Control Box is located on the stand outside the MSR.
::3.  Eye Tracking Computer
+
::2.  Press the Red ON/OFF switch to turn the power on and off for the Infrared Light Power Supply (SEC 1212).
::4.  Eye Tracking Software
+
<br>
 +
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 +
<br>
  
 +
===<big>'''Data Acquisition '''</big>===
  
<div align="center">'''''*See MEG Core staff for setup.'''''</div>
 
  
 
+
==== '''Data Acquisition''' ====
 
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<br>
 
 
 
===='''Response Devices 6.40'''====
 
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 1,780: Line 1,862:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Response Devices'''<br>
+
'''Data Acquisition'''<br>
'''Policy No. 6.40'''
+
'''Policy No. 7.00'''
 
|style="width: 650px"|
 
|style="width: 650px"|
'''Date: 1/03 <br>
+
'''Date: 10/03 <br>
'''Reviewed: 10/03; Revised: 8/06; 11/08; 1/12; 1/15; 2/18'''<br>
+
'''Revised: 6/06; 11/08; 1/12; 1/15; Reviewed: 2/18; 8/18'''<br>
 +
 
 
<br>
 
<br>
 
|-
 
|-
Line 1,794: Line 1,877:
 
|-
 
|-
 
|}
 
|}
 
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Acquisition Computer will be utilized in accordance with manufacturer's recommendations and MEG Core guidelines.'''
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The various response systems will provide for subject response monitoring via an electronics interface which will output to the acquisition computer to observe or examine response input and / or response time.'''
 
 
 
  
 
'''Procedure:'''
 
'''Procedure:'''
  
::'''I. Lumitouch Response Pad'''
+
:The Acquisition Computer controls all aspects of electronics, tuning, aquisition and data storage. The Acquisition Computer is configured with CTF's Omega software. Users are prohibited from attempting to alter the Acquisition computer setup in any way, and should not access any maintenance functions. Please see MEG Core staff for training in operating the Acq computer.
::'''The Lumitouch is a fiber optic response keypad where there are five response buttons arranged in a row to correspond to the thumb and the fingers. The response keypads and cabling are fabricated from 100% plastic materials and therefore do not cause electromagnetic interference.  The fiber-optic cables run from the pads through a wave guide to a controller box which is connected to the stimulus PC via a USB cable.'''
 
 
 
::::1.  Place the response pad on the left or right arm rest.
 
 
 
::::2.  Arrange fingers so that all or a subset of fingers can be used in natural
 
::::order and positioning when responding to visual and/or auditory stimuli.
 
 
 
::::3. Place the cables so that they are not on the MEG chair’s track when the chair is being moved.
 
 
 
::::4.  Instruct the subject in the use of the Lumitouch Response Keypad for the research study task.
 
  
 
<br>
 
<br>
::'''II.  FORP Response Pad'''
+
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
::'''The FORP is a Fiber-Optic Response Pad (FORP) where the 4 keys arranged in a diamond pattern.  There are 4 colored buttons which are arranged in a diamond pattern: Blue=1, Yellow=2, Green=3, Red=4.  The response keypads and cabling are fabricated from 10% plastic materials and therefore do not cause electromagnetic interference. The fiber-optic cables run from the pads through a wave guide to a controller box which is connected to the stimulus PC via a USB cable.'''
+
<br>
  
::::1.  Instruct the subject to hold or cup the response pad in the dominant or non-dominant hand while using the thumb to respond to the appropriate color, position, number or pattern.  ::::Position the pad so that the cable is in the superior orientation.
+
===<big>'''Infection Prevention / Control'''</big>===
  
::::2.  Place the cables so that they are not on the MEG chair’s track when the chair is being moved.
+
==== '''Infection Control / Universal Precautions''' ====
 
+
'''National Institute of Mental Health'''
::::3.  Instruct the subject in the use of the FORP Response Pad for the research study task.
+
{| class="wikitable"
 
 
<br>
 
::'''III.  Joy Stick Control'''
 
::'''The Joy Stick is a manual input device with a moveable control lever that can be tilted in various directions to control pointing devices or on-screen objects used for graphic applications.'''
 
 
 
::::1.  Instruct the subject to grasp the joystick control lever.
 
 
 
::::2.  Place the cable so that they are not on the MEG chair’s track when the chair is being moved.
 
 
 
::::3.  Instruct the subject in the use of the joystick for the research study task.
 
 
 
<br>
 
::'''IV.  Motion Detector'''
 
::'''The laser Motion Detector is a device that contains a physical mechanism or electronic sensor that quantifies movement which is integrated with or connected to other devices that alert the user of the presence of a moving object within the field of view.'''
 
 
 
<br>
 
::'''V.  Optical Microphone'''
 
::'''An Optical Microphone is an acoustic-to-electric transducer or sensor that converts sound into an electrical signal.'''
 
 
 
<br>
 
::'''VI.  Pneumatic Air Pressure Device'''
 
::'''The Pneumatic Air Pressure Device is attached to the pressure response ball which the subject squeezes to indicate a response. The unit can be calibrated for a gradated response or the thresholds can be set to give an on / off response.'''
 
 
 
 
 
 
 
 
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<br>
 
 
 
===='''Stimulation Devices 6.45'''====
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
 
|style="width: 350px"|
 
|style="width: 350px"|
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Stimulation Devices'''<br>
+
'''Infection Control / Universal Precautions'''<br>
'''Policy No. 6.45'''
+
'''Policy No. 9.00'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 10/03; Revised: 8/06; 11/08; 1/12; 1/15; 2/18'''<br>
+
'''Reviewed: 11/03; Reviewed: 11/03; Revised: 8/06; 7/07; 11/08; 1/12; 1/15; Reviewed: 2/18; Revised 8/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 1,870: Line 1,909:
 
|-
 
|-
 
|}
 
|}
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: Infection Control practices and procedures will be in place in order to interrrupt the spread of infection at the point of transmission between source and host. Protective clothing, safety goggles and gloves will be used as needed. Proper hand hygiene practices will be observed. All MEG staff are required to take the Universal Precautions and Transmission Based Precautions course through the hospital Epidemiology Office (HES), and adhere to the Clinical Center’s infection prevention / infection control policy and procedures, in addition to MEG Lab practices.'''
 +
<br>
 +
 +
'''Procedures'''
 +
<br>
 +
::'''I.  Standard / Universal Precautions include these practices:'''
  
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The various stimulation devices provide for subject stimulation via an electronics interface which will output to the acquisition computer to observe or examine <br>response input, subject reaction and / or response time.'''
+
::::1. '''Hand Hygiene''' – See [[Policies and Procedures#Hand Hygiene, Cleaning & Washing Procedures | Hand Hygiene, Cleaning & Washing Procedures]]
  
'''Procedure:'''
+
::::2.  '''Use of protective barriers / personal protective equipment (PPE)''', which will include:
 +
::::::a. '''Gloves - (latex or latex-free non-sterile gloves)
 +
::::::::i. During EEG/ EMG / Evoked Fields set up and clean up;
 +
::::::::ii. When abrading the skin;
 +
::::::::iii. When applying, handling and processing electrodes;
 +
::::::::iv. When hands are likely to be contaminated with blood, body fluids, secretions or excretions;
 +
::::::::v. When handling any equipment that comes in contact with subjects with a known infection.
  
::'''I.  Air Puff Stimulator'''
+
::::::b.  '''Gowns / Plastic apron –'''
::The Air Puff Stimulator is a tactile sensory nerve stimulator. The Air-puff stimulator is applied to the fingertipIt produces a puff of air which provides tactile stimulation that <br>produces a measurable sensory response in the nerve.
+
::::::::i. Usually not indicated for routine MEG Scans;
 +
::::::::iiTo be worn during activities that are likely to generate splashes.
  
::'''IILED Flasher'''  
+
::::::c. '''Masks –'''
::The LED Flasher is a light emitting diode which flashes a red strobe light for visual system stimulation.
+
::::::::i.  Usually not indicated for routine MEG scans;
 +
::::::::ii.  To be worn wherever splashes, spray, spatter or droplets may be generated toward the eyes, nose or mouth (in these situations wear a mask and eye protection or a chin length face shield).
 +
 
 +
::::::d. '''Protective Eyewear (i.e., eye shields or goggles) –'''
 +
::::::::i.  Usually not indicated routine MEG scans;
 +
::::::::ii.  To be worn wherever splashes, spray, spatter or droplets may be generated toward the eyes, nose or mouth (in these situations wear a mask and eye protection or a chin length face shield).
 +
 
 +
::::3.  '''Appropriate handling and disposal of sharps and other contaminated or infectious waste –'''
 +
::::::a.  All sharp items including needles and blunted needle tips will be disposed of in a Sharps Container.
 +
::::::b.  Sharps container will be disposed of when ¾ full; seal container closed and place in a Medical Pathological Waste (MPW) box.
 +
::::::c.  All disposable items contaminated with blood, body fluids, secretions or excretions will be disposed of in a MPW box.
 +
 
 +
::::4.  '''Use of Aseptic techniques- to control microorganisms in the environment-'''
 +
::::::a.  Cleaning – removal of all foreign materials using isopropyl alcohol (i.e., soil, organic material) from objects. Cleaning must precede disinfection and sterilization procedures.
 +
::::::b.  Decontamination – using Dispatch (1:10 solution of Sodium Hypochlorite) renders instrument surfaces safe to handle by reducing microbial burden.
 +
::::::c.  Disinfection – items are sent to Central Sterile Supply where a chemical or physical agent is used to eliminate nearly all recognized pathogenic organisms but not necessarily all microbial forms on inanimate objects.
 +
 
 +
:::::5.  '''Use of Sterilization –''' items are sent to Central Sterile Supply where:
 +
::::::a. Gas is used to eliminate or destroy all forms of microbial life, especially microorganisms and spores.
 +
 
 +
::'''II.  Transmission Based Precautions – additional precautions which are designed to interrupt transmission of known infections which should be used in addition to Standard / Universal Precautions when transmission of known infections might not be contained by using Universal Precautions alone.  Transmission based precautions are based upon and used for patients known or suspected to be infected or colonized with epidemiologically important or highly transmissible pathogens that can cause infections:'''
 +
 
 +
::::::1.  '''Respiratory Precautions –'''
 +
::::::::a. Airborne Transmission (i.e., tuberculosis, measles virus, chickenpox virus);
 +
::::::::b.  Acid Fast Bacilli (AFB) (i.e., tuberculosis) or
 +
::::::::c.  Droplet Transmission (i.e., mumps, rubella, pertussis, influenza);
 +
 
 +
::::::2.  '''Contact Precautions -''' Direct or Indirect Contact dry skin (i.e., colonization with Multi-Resistant Staphylococcus Aureus [MRSA], ringworm, head lice, scabies) or
  
::'''III.  PIEZO BUZZER'''
+
::::::3.  '''Strict Precautions -''' Any combination of these routes.  *See IC Flipchart.
::A buzzer device which has no moving parts which uses the electromechanical interaction between the mechanical and the electrical state in a crystalline material to measure <br>pressure, acceleration, strain or force and converts them to an electrical charge.  
+
::::::4.  '''CNS Precautions –''' contact with blood or body fluids especially cerebral spinal fluid (CSF).
  
  
 +
References:
 +
::::1.  National Institute of Health, Clinical Center Hospital Epidemiology Service (HES); http://intranet.cc.nih.gov/hospitalepidemiology/ .
 +
::::2.  OSHA Infections Control Guidelines; https://www.osha.gov/SLTC/healthcarefacilities/infectious_diseases.html.
 +
::::3.  CDC Infections Control Guidelines; https://www.cdc.gov/hicpac/pdf/core-practices.pdf .
  
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
<br>
 
  
===='''Video Camera Operation 6.60'''====
+
===='''Hand Hygiene, Cleaning & Washing Procedures'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 1,895: Line 1,977:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Video Camera Operation'''<br>
+
'''Hand Hygiene, Cleaning & Washing Procedures'''<br>
'''Policy No. 6.60'''
+
'''Policy No. 9.20'''
 
|style="width: 650px"|
 
|style="width: 650px"|
'''Date: 11/03 <br>
+
'''Date: 1/03 <br>
'''Reviewed: 8/06; 11/08; Revised: 1/12; 1/15; 2/18'''<br>
+
'''Reviewed: 11/03; Reviewed: 11/03; Revised: 8/06; 7/07; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 1,909: Line 1,991:
 
|-
 
|-
 
|}
 
|}
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: Hand hygiene/washing procedures will be instituted to prevent the transmission of infectious disease from subject to subject, patient to patient and to or from <br>subject /patient to staff.'''
  
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: Video cameras are used to view and monitor subject inside the MSR on the Video Display Monitor and, to record subjects to digital video media (VHS or DVD) <br>using the Video Cassette Recorder.  The video camera system will be utilized in accordance with the manufacturer’s guidelines and MEG Core Facility policies and procedures.'''
+
<br>  
 
 
<br>
 
'''There are two cameras located inside the MSR: 1) an infrared and 2) a color camera.  The infrared camera is displayed on Channel 1; the color camera is displayed on Channel 2. 
 
<br>
 
  
 
'''Procedure:'''
 
'''Procedure:'''
 +
::::'''I.  Steps to Assure Effective Hand Hygiene:'''
 +
::::::a.  Keep nails short and neat.  Cracked or chipped nail polish provides crevices for organisms.
  
<br>
+
::::::b.  Limit wearing of hand and wrist jewelryJewelry provides crevices for organisms.
::1Position / Re-position cameras manually for optimal viewing / display.
 
  
::2Press the channel button located on the Video Display Monitor to change from Camera 1 to Camera 2 or vice versa.   
+
::::::cDry, cracked, broken skin increases chance of harboring transient bacteriaDry hands well.  Do not over use antimicrobials. Use hand lotion.
  
 +
::::::d.  Liquid soap from a dispenser is preferred, however, if bar soap is used, rinse soap after use and keep on racks that allow drainage of water.
  
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
+
::::'''II.  What to Use for Hand Hygiene:'''
<br>
+
::::::'''1.  Antimicrobial Soap and Water'''
 +
::::::::Hands must be washed using an antimicrobial soap (Bactifoam) and running water. <br>In the absence of a true emergency, personnel should always wash their hands with soap and water. <br>If hands are visibly soiled they must be washed using an antimicrobial soap and running water as soon as possible.
  
===='''Voice Intercom System 6.70'''====
+
::::::'''2. Alcohol Based Gels'''
'''National Institute of Mental Health'''
+
::::::::If hand washing using soap and running water is not possible an alcohol gel such as Avagard D (61% alcohol) may be used.  <br>Alcohol gel products do not require water.
{| class="wikitable"
 
|style="width: 350px"|
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''Voice Intercom System'''<br>
 
'''Policy No. 6.70'''
 
|style="width: 650px"|
 
'''Date: 11/03 <br>
 
'''Reviewed: 8/06; 11/08; Revised: 1/12; 1/15; 2/18'''<br>
 
<br>
 
|-
 
|
 
'''Recommended By:'''<br>
 
'''MEG Core Facility Staff'''<br>
 
|
 
'''Distribution: MEG Core Facility'''
 
|-
 
|}
 
  
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Voice Intercom System will be used to facilitate communications with subjects while inside the Magnetically Shielded Room (MSR).'''
 
  
<br>
+
::::'''III.  How to Wash Hands:'''
'''The Voice Intercom System consists of:'''
+
::::::a. Use continuously running water.
::::'''1. The Intercom Electronics Box - located at the acquisition workstation / operator’s console. The Intercom Electronics Box allows the MEG operator to adjust the volume level at the console and the volume level inside the MSR independently. When at the Acquisition Console, the MEG operator can communicate with the subject inside the MSR through this device. This system works like a Walkie-Talkie, that is, when the operator is talking (depressing the “talk” button he/she cannot hear the subject and when he/she releases the button he/she can hear the subject speaking).'''
 
  
<br>
+
::::::bWet hands thoroughly.
::::'''2.  Parabolic Microphone - located inside the MSRIt is used to pick up and amplify the subject’s voice so that it can be heard at the operator’s console in order to facilitate communication between the subject and the operator.
 
'''
 
  
<br>
+
::::::cDispense enough hand soap for a good lather.
::::'''3Flat Speaker - located inside the MSR. It is used to pick up and amplify the operator’s voice so that it can be heard by the subject inside the MSR.'''
 
  
<br>
+
::::::d.  Vigorously rub together all surfaces of lathered hands for at least 10 seconds.  <br>Take care not to break or abrade your skin.
::::::::::::::::::'''''*There are no intercom controls inside the MSR.'''''
 
  
<br>
+
::::::e.  Keep hands down at all times so run off goes into sink and not down arms.  <br>Avoid splashing.
'''Procedure:'''
 
  
::1Press the Red power button to turn ON the Intercom Electronics Box.
+
::::::fRinse thoroughly under a stream of water.
  
::2Press the PUSH TO TALK button located on the front of the Intercom Electronics Box to speak to a subject inside the MSR.  
+
::::::gDry hands well with paper towel.
  
::3Release the button to hear the subject speak.
+
::::::hAfter washing turn off hand operated faucets with clean dry paper towel and <br>dispose of properly.
  
::4Adjust the volume inside the MSR, so that the subject inside the MSR can hear the operator, using the knob labelled “MSR” located on the Intercom Electronics Box.
+
 
+
::::'''IVHow to Clean Hands Using Alcohol Based Gels:'''
::5Adjust the volume at the Acquisition Workstation / Operator’s Console, so that the operator at the console can hear the subject, using the knob labelled “Console” <br>on the Intercom Electronics Box.
+
::::::aApply to dry hands.
  
 +
::::::b.  Apply enough to moisten all hand surfaces (front and back).
  
 +
::::::c.  Rub hand together for 20 seconds; cover all surfaces of the hands, <br>fingers and nails.
  
 +
::::::d.  Allow hands to dry.
  
Reference:
+
::::::eDo not wipe off excess gel; rub on skin until dry.
::1MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
 
  
 +
::::::f.  After every 10 applications of hand gel, perform hand hygiene with soap and running water.
  
 +
::::::g.  If hands are visibly soiled they must be washed using soap and water.
  
  
 +
::::'''V.  When to Clean Hands:'''
 +
::::::•  At reporting to work (at the beginning of your shift);
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
+
::::::•  At the beginning and end of each MEG scan;
<br>
 
  
===='''Video Display Monitor 6.80'''====
+
::::::•  Before and after subject/patient contact;  
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
|style="width: 350px"|
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''Video Display Monitor'''<br>
 
'''Policy No. 6.80'''
 
|style="width: 650px"|
 
'''Date: 11/03 <br>
 
'''Reviewed: 8/06; 11/08; Revised: 1/12; 1/15; 2/18'''<br>
 
<br>
 
|-
 
|
 
'''Recommended By:'''<br>
 
'''MEG Core Facility Staff'''<br>
 
|
 
'''Distribution: MEG Core Facility'''
 
|-
 
|}
 
  
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Video Display Monitor will be used to monitor subjects inside the MSR.'''
+
::::::•  Before and after touching high risk subjects or patients <br>(before taking care of a particularly susceptible patient – i.e., severely immuno-compromised).
  
<br>
+
::::::•  After contact with blood or other body fluids, secretions, or excretions.
'''The Video Display Monitor which is located at the acquisition workstation / operator’s console is used to monitor subjects inside the MSR. MEG users will observe the subject at all times while inside the MSR. There are currently two channels / two cameras in use for subject observation. Each camera is located or mounted at a different angle. Select the camera angle that is best for viewing the subject and any related equipment.'''
 
  
 +
::::::•  Before donning gloves;
  
'''Procedure:'''
+
::::::•  After removing gloves- gloves can become perforated during use; <br>bacteria can multiply rapidly on gloved hands.
 +
 
 +
::::::•  After touching objects that are likely to be contaminated with microorganisms <br>(e.g., equipment or other items, keyboards, telephones, doorknobs, stair banister, etc.
 +
 
 +
::::::•  After applying or adjusting electrodes.
 +
 
 +
::::::•  After removing electrodes and cleaning hair and scalp.
  
::a. To turn the monitor on - press the ON/OFF switch located on the front panel of the Video Display Monitor.  
+
::::::• After handling electrodes for cleaning or after disinfecting.
  
::b. Press the channel button once to access the next channel.
+
::::::• Before and after eating.
  
::c. Continue to press the channel button to access the other channels.
+
::::::• Whenever hands are soiled;
  
::::::::::::::::::::::{| class="wikitable"
+
::::::•  After going to the bathroom.
|-
 
| '''Channel 1''' || Camera 1 (Infrared Camera)
 
|-
 
| '''Channel 2''' || Camera 2 (Color Camera)
 
|-
 
| '''Channel 3''' || VCR Play back
 
(connected to Color Camera)
 
|-
 
| '''Channel 4''' || (Blank)
 
|}
 
                 
 
  
:::::::::::::::::'''*Always monitor subjects via the Video Display Monitor when running a study.'''
+
::::::•  After blowing or wiping nose, coughing or sneezing.
  
::::::::::::::::::'''''THE SUBJECT MUST BE OBSERVED AT ALL TIMES DURING TESTING.'''''
 
  
 +
References:
 +
::1.  Refer to the CC Handwashing Policy.
 +
::2.  National Institute of Health, Clinical Center Hospital Epidemiology Service (HES); http://intranet.cc.nih.gov/hospitalepidemiology/ .
 +
::3.  OSHA Infection Control Guidelines; www.osha.gov
 +
::4.  CDC Infection Control Guidelines: www.cdc.gov
  
  
  
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 +
 +
 
<br>
 
<br>
  
===='''Infrared Lighting 6.90'''====
+
===='''Cleaning, Disinfection & Sterilization of MEG Equipment'''====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 2,055: Line 2,099:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Infrared Lighting'''<br>
+
'''Cleaning, Disinfection & Sterilization of MEG Equipment'''<br>
'''Policy No. 6.90'''
+
'''Policy No. 9.30'''
 
|style="width: 650px"|
 
|style="width: 650px"|
'''Date: 11/03 <br>
+
'''Date: 1/03 <br>
'''Reviewed: 8/06; 11/08; Revised: 1/12; 1/15; 2/18'''<br>
+
'''Reviewed: 11/03; Reviewed: 12/03; Revised: 8/06; 7/07; 3/09; Reviewed: 4/10; 5/11; 6/12; 7/14; 1/15; Revised: 2/18; 8/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 2,069: Line 2,113:
 
|-
 
|-
 
|}
 
|}
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: In order to interrupt the spread of infection at the point of transmission between sources and host: 1) all non-disposable equipment will be properly cleaned, disinfected and/or sterilized between uses and, 2) all single use equipment will be properly disposed. All MEG Users using electrodes and / or cap applications will be trained by the MEG technologist regarding specific MEG Lab Infection Control policies and procedures.'''
 +
<br>
 +
'''I.  <u>Personal / Workspace Protections</u>''' 
 +
::::'''1. Gloves will be used when:'''
 +
:::::a. Abrading skin,
 +
:::::b. Cleaning, disinfecting or handling equipment used on abraded skin,
 +
:::::c. Handling all soiled instruments and equipment,
 +
:::::d. In contact with a patient/subject with a known infectious disease,
 +
:::::e. In accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.
  
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The Infrared Light will be utilized in accordance with the manufacturer’s guidelines
+
::::'''2. Workspace Protective Impervious Barrier are used:''' -
and MEG Core Facility policies and procedures.'''
+
:::::a. To cover the work area when abrading the skin to place “contaminated/used” equipment or supplies. 
 +
:::::b. When temporarily maintaining any item considered contaminated if needed for additional use,
 +
:::::c. To place all soiled instruments and equipment,
 +
:::::d. To place items that have come in contact with a patient/subject with a known infectious disease,
 +
:::::e. In accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.
 +
::::f. Any items placed on this barrier will be considered contaminated and must be disposed of or cleaned using Dispatch or Asepti-Wipe II.
 +
::::g. The barrier will be discarded after each use and the physical work surface will be disinfected using Hydrogen Peroxide Disinfectant, Dispatch or Asepti-Wipe II.
  
 +
<br>
 +
'''II.  <u>Non-portable non-disposable / reusable equipment</u>''' 
 +
::::'''1.  Routine Cleaning Procedure'''
 +
:::::a. All Non-Disposable Immobile or Non-Immersable equipment that comes in contact with a subject/patient will be routinely cleaned by the person(s) conducting the MEG scan using a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl alcohol or isopropyl alcohol after each subject/patient use. 
  
'''The Infrared Light illuminates the inside of the MSR when recording in a dark environment so that the subject may be seen via the Video Display Monitor.   The Infrared Light Control Box is located on the stand outside the MSR.'''
+
:::::::{| class="wikitable"
 
+
|-
 +
| Materials Required: || Gloves, a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.
 +
|-
 +
| Responsibility: || Each User
 +
|-
 +
| Frequency: || After each use.
 +
|}
  
''''Procedure:'''
+
::::'''2.  Known Infectious Disease Procedure'''  
 +
:::::a. Most EEG/MEG equipment (other than electrodes and caps) usually poses no significant hazard of infection transmission, however, when used by a patient with a known infectious disease the equipment will be disinfected in compliance with Transmission Based Precautions by each User after each subject/patient use.
  
::1.  Press the Red ON/OFF switch to turn the power on and off for the Infrared Light Power Supply (SEC 1212).
+
:::::::::{| class="wikitable"
 +
|-
 +
| Materials Required: || Gloves, Prepping (Blue) Pad, Disposable Wash Cloth, a hospital approved disinfectant <br>such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.
 +
|-
 +
| Responsibility: || Each User
 +
|-
 +
| Frequency: || After each use.
 +
|}
 +
<br>
 +
'''III.  <u>Portable non-disposable / reusable equipment</u>'''
 +
::'''1.  Routine procedure for equipment used on abraded skin:'''
 +
:::::a. All portable non-disposable equipment used on abraded skin will be treated as in [[Policies and Procedures#Infection Control - EEG Caps & Electrodes|Infection Control - EEG Caps & Electrodes]]
  
                                                                                       
+
<br>
 +
::'''2.  Routine Procedure for equipment used on un-abraded skin'''
 +
:::::a. All Portable Non-Disposable equipment, i.e., head localization coils, that comes in contact with un-abraded and otherwise intact skin (including sweat) will be cleaned using a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl alcohol or isopropyl alcohol.
 +
 +
<br>
 +
:::::::::{| class="wikitable"
 +
|-
 +
| Materials Required: || 70-90% Ethyl Alcohol, Isopropyl Alcohol, Alcohol Prep Pads, and gloves
 +
|-
 +
| Responsibility: || Each User
 +
|-
 +
| Frequency: || After each use
 +
|-
 +
| Transport to CHS: || MEG Staff
 +
|}
  
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
 
<br>
 
<br>
 +
::::'''Procedure:'''
 +
:::::i.  Wash hands.
 +
:::::ii.  Wipe the Head Localization Coils with alcohol.
 +
:::::iii. Adhesive Remover may be used occasionally to remove any adhesive buildup or sticky residue.
 +
:::::iv.  Wash hands.
  
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 
  
===<big>'''Data Acquisition / Data Analysis (7.00)'''</big>===
+
::'''3.  Known Infectious Disease (Abraded Skin or Un-Abraded Skin)'''
 +
::::a. All Portable Non-Disposable / Reusable Equipment used by a patient with a known infectious disease will treated as equipment used on abraded skin ([[Policies and Procedures#Infection Control - EEG Caps & Electrodes|Infection Control - EEG Caps & Electrodes]]) and be sent to CHS for disinfection /sterilization.
  
 +
'''IV.  <u>Disposable / single use equipment</u>'''
  
==== '''Data Acquisition 7.00''' ====
+
::'''1. Routine Procedure for Single Use Equipment used on Abraded or Un-abraded Skin'''
'''National Institute of Mental Health'''
+
:::a. All Disposable / Single Use Equipment used abraded skin will be disposed of in the trash.  Gloves will be used when abrading the skin.
{| class="wikitable"
 
|style="width: 350px"|
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''Data Acquisition'''<br>
 
'''Policy No. 7.00'''
 
|style="width: 650px"|
 
'''Date: 10/03 <br>
 
'''Revised: 6/06; 11/08; 1/12; 1/15; Reviewed: 2/18'''<br>
 
  
<span style="color:red">'''CURRENTLY UNDER REVISION'''</span>
 
 
<br>
 
<br>
|-
+
::'''2.  Known Infectious Disease (Single Use Equipment)'''
|
+
:::b. All Disposable / Single Use Equipment used by a patient with a known infectious disease must be disposed of in a '''<u>Medical Pathological Waste (MPW) Box</u>'''.
'''Recommended By:'''<br>
+
 
'''MEG Core Facility Staff'''<br>
+
<br>
|
+
'''Distribution: MEG Core Facility'''
+
'''V. <u>Adverse Occurrences:</u>'''
|-
+
::'''1.  Course of Action for Adverse Occurrence / Exposure to an infectious agent.'''
|}
 
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''The Acquisition Computer will be utilized in accordance with manufacturer's recommendations and MEG Core guidelines.'''
 
 
 
The Acquisition Computer controls all aspects of electronics, tuning, aquisition and data storage. The Acquisition Computer is configured with CTF's Omega software.
 
 
 
 
 
 
 
  
 +
:::a.  Follow the Clinical Center Infection Control Guidelines in accordance with the specific kind of exposure.
 +
:::b.  Report to Occupational Medical Service (OMS).
 +
:::c.  Fill out a MEG Problem Report form.
  
 +
<br>
 +
'''References:'''
 +
::1.  National Institute of Health, Clinical Center Hospital Epidemiology Service: http://intranet.cc.nih.gov/hospitalepidemiology/ .
 +
::2.  OSHA Infection Control Guidelines: www.osha.gov
 +
::3.  CDC Infection Control Guidelines; www.cdc.gov
  
 +
<br>
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<br>
 
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 
 
<br>
 
<br>
  
===<big>'''Infection Prevention / Control (9.00)'''</big>===
+
===='''Infection Control - EEG Caps & Electrodes'''====
 
 
==== '''Infection Control / Universal Precautions 9.00''' ====
 
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 2,137: Line 2,223:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Infection Control / Universal Precautions'''<br>
+
'''Infection Control - EEG Caps & Electrodes'''<br>
'''Policy No. 9.00'''
+
'''Policy No. 9.40'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 11/03; Reviewed: 11/03; Revised: 8/06; 7/07; 11/08; 1/12; 1/15; Reviewed: 2/18'''<br>
+
'''Reviewed: 2/18; Revised: 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 2,151: Line 2,237:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: Infection Control practices and procedures will be in place in order to interrrupt the spread of infection at the point of transmission between source and host.  <br>Protective clothing, safety goggles and gloves will be used as needed. Proper hand hygiene practices will be observed.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: All non-disposable EEG caps and electrodes that come in contact with skin that has been abraded will be considered “contaminated”. Non-disposable electrodes and EEG caps will be sent to Hospital Environmental Services (HES) for disinfection / sterilization. *With the exception of the VSM Easycap which will be transported to the NINDS EEG Department for disinfection as per specific manufacturer’s instructions as outlined in [[Policies and Procedures#VSM Easycap (Model B-VSM-0123) Electrode & Cap Maintenance, Cleaning & Disinfection|VSM Easycap Electrode & Cap Disinfection]]'''
  
 +
'''Procedure:'''
 
<br>
 
<br>
'''<u>Infection Control Training</u> - All MEG staff are required to take the annual training /retraining regarding Standard / Universal Precautions and Transmission Based Precautions <br>through the hospital Epidemiology Office (HES)All documentation of training will be maintained by MEG staff as part of the MEG Quality Assurance / Risk Management <br>/ Compliance Program.'''
+
:::::::::{| class="wikitable"
 +
|-
 +
| Materials Required: || Gloves, Prepping (Blue Pad), Disposable Wash Cloth, Biohazard Transport Container, <br>Zip Lock Specimen Bag (2), Steam / Gas Sterilization Request Form, <br>Contents/ Warning Label, Marker, MPW Box, and a hospital approved <br>disinfectant such as Hydrogen Peroxide, 70-90% ethyl or isopropyl alcohol.  
 +
|-
 +
| Responsibility: || Each User / Research Assistant
 +
|-
 +
| Frequency: || After each use
 +
|-
 +
| Transport to CHS: || MEG Staff
 +
|}
  
 
<br>
 
<br>
'''The NIH infection prevention / control methods and procedures incorporate Universal Precautions (OSHA) and Standard Precautions (CDC).  Herein the NIH procedure <br>will be referred to as Standard / Universal Precautions.'''
 
  
<br>
+
::'''I.  Non-Disposable Electrodes(s) – e.g., Silver/Silver Chloride Disc Electrodes, Gereonics Silver /Silver Chloride Electrodes, Grass Gold Electrodes'''
'''<u>Infection Control Procedures</u> - MEG staff and MEG users are required to adhere to the Clinical Center’s infection prevention / infection control policy and procedures, <br>in addition to MEG Lab practices.'''
 
  
<br>
+
::::1.  Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin.  For individuals sensitive to latex, nitrile rubber gloves may be used.
'''<u>Universal Precautions</u> - will be employed based upon the contact with blood, body secretions, excretions, non-intact skin, and mucous membranes. Anyone who has patient <br>contact and / or the potential for occupational exposure to human blood and body fluids are required to adhere to infection prevention / infection control practices.''' 
 
  
<br>
+
::::2Place the disk end of the electrode in the zippered section of the 2-pocket zip lock plastic bag.   
'''<u>Standard Precautions</u> - consists of work practices which are employed as a mean of standard / basic level of infection control which will be followed for all subjects/patients<br> regardless of whether an infectious disease is identified whenever there is a potential for the transmission of pathogensStandard precautions integrate and expand the <br>elements of universal precautions into a standard of care designed to prevent transmission by blood or any other body fluid, excretion, or secretions (except sweat), <br>regardless of whether they contain blood, or is from non-intact skin or mucous membranes.'''
 
   
 
<br>
 
'''<u>Transmission Based Precautions</u> - will also be utilized to interrupt the transmission of known infections.
 
  
::'''IStandard / Universal Precautions include these practices:'''
+
::::3Place the wire end in the un-zippered pocket of the zip lock plastic bag.
  
::::1'''Hand Hygiene''' – using soap and water or alcohol hand gel must be performed in each of these situations:
+
::::4Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.   
::::::•  After reporting to work (at the beginning of your shift);
 
::::::•  At the beginning and end of each MEG scan;
 
::::::•  Before and after subject/patient contact;
 
::::::•  Before donning gloves
 
::::::•  After removing gloves and other personal protective equipment;
 
::::::•  After touching objects that are likely to be contaminated with microorganisms (e.g., equipment or other items, <br>keyboards, <be>telephones / cell phones, doorknobs, stair banister, etc.
 
::::::•  Whenever hands are visibly soiled
 
::::::•  After sneezing, coughing or blowing your nose;
 
::::::• After contact with blood, or other potentially infectious material and equipment or articles;
 
  
::::2'''Use of protective barriers / personal protective equipment (PPE)''', which will include:
+
::::5Place the lid on the Biohazard Container.
::::::•  Gloves - (latex or latex-free non-sterile gloves)
 
::::::::o  During EEG/ EMG / Evoked Fields set up and clean up;
 
::::::::o  When abrading the skin;
 
::::::::o  When applying, handling and processing electrodes;
 
::::::::o  When hands are likely to be contaminated with blood, body fluids, secretions or excretions;
 
::::::::o  When handling any equipment that comes in contact with subjects with a known infection.
 
  
::::::• '''Gowns / Plastic apron –'''
+
::::6. Place the Biohazard Container on the top shelf of the Environmental Services Department (ESD) Processing Cart.
::::::::o  Usually not indicated for routine MEG Scans;
 
::::::::o  To be worn during activities that are likely to generate splashes.
 
  
::::::• '''Masks –'''
+
::::7. Fill out a “Steam/Gas Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.
::::::::o  Usually not indicated for routine MEG scans;
 
::::::::o  To be worn wherever splashes, spray, spatter or droplets may be generated toward the eyes, nose or mouth <br>(in these situations wear a mask and eye protection or a chin length face shield).
 
  
::::::•  '''Protective Eyewear (i.e., eye shields or goggles) –'''
+
::::8.  MEG staff will transport the Biohazard Container to ESD for disinfection/sterilization.  
::::::::o Usually not indicated routine MEG scans;
 
::::::::o  To be worn wherever splashes, spray, spatter or droplets may be generated toward the eyes, nose or mouth <br>(in these situations wear a mask and eye protection or a chin length face shield).  
 
  
::::3'''Appropriate handling and disposal of sharps and other contaminated or infectious waste –'''
+
::::9Biohazard Containers with “contaminated” equipment will be logged in and out per ESD procedures.
::::::::o  All sharp items including needles and blunted needle tips will be disposed of in a Sharps Container.
 
::::::::o  Sharps container will be disposed of when ¾ full; seal container closed and place in a Medical Pathological Waste (MPW) box.
 
::::::::o  All disposable items contaminated with blood, body fluids, secretions or excretions will be disposed of in a MPW box.  
 
  
::::4.  '''Use of Aseptic techniques- to control microorganisms in the environment-'''
 
::::::::•  Cleaning – removal of all foreign materials using isopropyl alcohol (i.e., soil, organic material) from objects.  <br>Cleaning must precede disinfection and sterilization procedures.
 
::::::::•  Decontamination – using Dispatch (1:10 solution of Sodium Hypochlorite) renders instrument surfaces safe <br>to handle by reducing microbial burden.
 
::::::::•  Disinfection – items are sent to Central Sterile Supply where a chemical or physical agent is used to eliminate nearly <br>all recognized pathogenic organisms but not necessarily all microbial forms on inanimate objects.
 
  
::::::5.  '''Use of Sterilization –''' items are sent to Central Sterile Supply where:
+
::'''II.  Non-disposable EEG Cap e.g., Easy Cap'''
::::::::•  Gas is used to eliminate or destroy all forms of microbial life, especially microorganisms and spores.
 
  
::'''IITransmission Based Precautions – additional precautions which are designed to interrupt transmission of known infections which should be used in addition <br>to Standard / Universal Precautions when transmission of known infections might not be contained by using Universal Precautions aloneTransmission based <br>precautions are based upon and used for patients known or suspected to be infected or colonized with epidemiologically important or highly transmissible <br>pathogens that can cause infections:'''
+
::::1Latex rubber gloves must be used whenever handling and/or processing an EEG Cap that has been used on abraded skinFor individuals sensitive to latex, nitrile rubber gloves may be used.
  
::::::1'''Respiratory Precautions –'''
+
::::2Removed all electrodes from the cap*The EEG Cap and electrodes will be processed separately.   
::::::::aAirborne Transmission (i.e., tuberculosis, measles virus, chickenpox virus);
 
::::::::b.  Acid Fast Bacilli (AFB) (i.e., tuberculosis) or
 
::::::::cDroplet Transmission (i.e., mumps, rubella, pertussis, influenza);
 
  
::::::2'''Contact Precautions -''' Direct or Indirect Contact dry skin (i.e., colonization with Multi-Resistant Staphylococcus Aureus [MRSA], ringworm, head lice, scabies) or
+
::::3Place the cap in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
  
::::::3'''Strict Precautions -''' Any combination of these routes.  *See IC Flipchart.
+
::::4Place the lid on the Biohazard Container.
  
::::::4'''CNS Precautions –''' contact with blood or body fluids especially cerebral spinal fluid (CSF).
+
::::5Place the Biohazard Container on the top shelf of the ESD processing cart.
  
 +
::::6.  Fill out the Gas Sterilization Request form and place on top of the appropriate closed container.
  
 +
::::7.  MEG staff will transport the Biohazard Container to ESD for disinfection / sterilization.
  
  
References:
+
'''References:'''
 
::::1.  National Institute of Health, Clinical Center Hospital Epidemiology Service (HES); http://intranet.cc.nih.gov/hospitalepidemiology/ .
 
::::1.  National Institute of Health, Clinical Center Hospital Epidemiology Service (HES); http://intranet.cc.nih.gov/hospitalepidemiology/ .
 
::::2.  OSHA Infections Control Guidelines; www.osha.gov .
 
::::2.  OSHA Infections Control Guidelines; www.osha.gov .
 
::::3.  CDC Infections Control Guidelines; www.cdc.gov .
 
::::3.  CDC Infections Control Guidelines; www.cdc.gov .
  
 +
<br>
 +
<div align="center">______________________________________________________________________________________________________________________________ </div>
  
 +
<br>
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
+
===='''VSM Easycap (Model B-VSM-0123) Electrode & Cap Maintenance, Cleaning & Disinfection'''====
 
 
===='''Hand Hygiene, Cleaning & Washing Procedures 9.20'''====
 
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 2,248: Line 2,308:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Hand Hygiene, Cleaning & Washing Procedures'''<br>
+
'''VSM Easycap (Model B-VSM-0123) Electrode & Cap Maintenance, Cleaning & Disinfection'''<br>
'''Policy No. 9.20'''
+
'''Policy No. 9.45'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 11/03; Reviewed: 11/03; Revised: 8/06; 7/07; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
+
'''Reviewed: 2/18; Revised: 2/18; Revised 9/20'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 2,262: Line 2,322:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: Hand hygiene/washing procedures will be instituted to prevent the transmission of infectious disease from subject to subject, patient to patient and to or from <br>subject /patient to staff.'''
+
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: Currently, VSM EasyCap and electrodes are used exclusively by the NINDS EEG Department. VSM EasyCap and electrodes will be cleaned and disinfected per manufacturers’ instructions in the NINDS EEG Department. Cleaning / disinfection will be performed using NIH approved chemical disinfectants according to Hospital Epidemiology Service requirements in hospital approved designated area(s) only. Additional laboratories wishing to use the VSM EasyCap should work with the MEG Core Facility and Hospital Epidemiology Service to deploy appropriate cleaning / disinfection procedures. '''
  
<br>  
+
<br>
 +
::'''References:'''
  
'''Procedure:'''
+
::::1National Institute of Health, Clinical Center Hospital Epidemiology Service.  
::::'''I.  Steps to Assure Effective Hand Hygiene:'''
 
::::::a.  Keep nails short and neatCracked or chipped nail polish provides crevices for organisms.
 
  
::::::bLimit wearing of hand and wrist jewelry.  Jewelry provides crevices for organisms.
+
::::2OSHA Infection Control Guidelines.  
  
::::::cDry, cracked, broken skin increases chance of harboring transient bacteria.  Dry hands well.  Do not over use antimicrobials. Use hand lotion.
+
::::3CDC Infection Control Guidelines.  
  
::::::dLiquid soap from a dispenser is preferred, however, if bar soap is used, rinse soap after use and keep on racks that allow drainage of water.
+
::::4EasyCap Recommendations / Instructions.
  
 +
===='''Drug Studies Infection Control Procedures'''====
 +
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Drug Studies Infection Control Procedures'''<br>
 +
'''Policy No. 9.50'''
 +
|style="width: 650px"|
 +
'''Date: 1/11 <br>
 +
'''Revised: 1/12; 1/15; 2/18'''<br>
 +
<br>
 +
|-
 +
|
 +
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility, 7NE Nursing Staff, Hospital Epidemiology Service (HES)'''
 +
|-
 +
|}
 +
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''During an MEG scan that involves drawing blood in the MEG Lab infection control procedures must be followed. All nurses participating in drug studies / protocols must follow all MEG Lab [[Policies and Procedures#Infection Prevention / Control|Infection Prevention / Infection Control Policies and Procedures]].'''
 +
<br>
  
::::'''II.  What to Use for Hand Hygiene:'''
+
'''In addition, all nurses assisting with blood draws in the MEG lab must comply with all Clinical Center Infection Control Policies and Procedures.'''
::::::'''1.  Antimicrobial Soap and Water'''
 
::::::::Hands must be washed using an antimicrobial soap (Bactifoam) and running water. <br>In the absence of a true emergency, personnel should always wash their hands with soap and water. <br>If hands are visibly soiled they must be washed using an antimicrobial soap and running water as soon as possible.
 
  
::::::'''2.  Alcohol Based Gels'''
 
::::::::If hand washing using soap and running water is not possible an alcohol gel such as Avagard D (61% alcohol) may be used.  <br>Alcohol gel products do not require water.
 
  
 +
'''Procedures:'''
 +
::::1.  All nurses participating in drug studies in the MEG Lab must attend MEG Lab specific Infection Control training.
  
::::'''IIIHow to Wash Hands:'''
+
::::2Gloves will be used when drawing blood or whenever touching the blood draw syringe or any potentially contaminated items.
::::::a.  Use continuously running water.
 
  
::::::bWet hands thoroughly.
+
::::3“Contaminated” gloves will be discarded before touching any other items in the MEG lab.
  
::::::cDispense enough hand soap for a good lather.
+
::::4After gloves are removed, hands must be washed / sanitized before touching any other “clean” items including MEG equipment, telephone and any computer keyboards.
  
::::::dVigorously rub together all surfaces of lathered hands for at least 10 seconds.  <br>Take care not to break or abrade your skin.
+
::::5All surfaces (prep table, cabinets) will be wiped with Dispatch after use.
  
::::::eKeep hands down at all times so run off goes into sink and not down arms.  <br>Avoid splashing.
+
::::6All MEG Lab staff will monitor participants for compliance.
  
::::::f.  Rinse thoroughly under a stream of water.
 
  
::::::g. Dry hands well with paper towel.
+
:::::::::''*Anyone who has not received MEG lab Infection Control training should contact the MEG Lab Manager as soon as possible.''
 +
::::::::::::::''**MEG staff will monitor hand washing in compliance with the CC Hygiene Initiative.''
  
::::::h.  After washing turn off hand operated faucets with clean dry paper towel and <br>dispose of properly.
+
<br>
 +
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 +
<br>
  
+
===<big>'''Quality Assurance and System Risk Management '''</big>===
::::'''IV.  How to Clean Hands Using Alcohol Based Gels:'''
 
::::::a.  Apply to dry hands.
 
  
::::::b.  Apply enough to moisten all hand surfaces (front and back).
+
===='''Calibration Procedures '''====
  
::::::c.  Rub hand together for 20 seconds; cover all surfaces of the hands, <br>fingers and nails.
+
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Calibration Procedures'''<br>
 +
'''Policy No. 10.10'''
 +
|style="width: 650px"|
 +
'''Date: 11/03 <br>
 +
'''Reviewed: 11/03; 8/06; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
 +
<br>
 +
|-
 +
|
 +
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility'''
 +
|-
 +
|}
  
::::::d.  Allow hands to dry.
+
'''Policy: Calibration procedures should be performed for quality assurance and in order to evaluate the performance of the MEG system.'''
  
::::::e.  Do not wipe off excess gel; rub on skin until dry.
+
<br>
  
::::::f. After every 10 applications of hand gel, perform hand hygiene with soap and running water.
+
:::::::::::::::{| class="wikitable"
 +
|-
 +
| '''CALIBRATION PROCEDURE:''' || '''''PERFORM WHENEVER:'''''
 +
|-
 +
| '''A. [[Policies and Procedures#MEG Noise Collection|Noise / Gain Measurement]]''' || '''''-there is line frequency noise'''''
 +
|-
 +
| '''B. [[Policies and Procedures#Head Coil Calibration|Head Coil Calibration]]''' || '''''-head localization results / accuracy is in doubt'''''
 +
|-
 +
| '''D. [[Policies and Procedures#Magnetic Phantom Measurement|Magnetic Phantom Measurement]]''' || '''''-the performance of the MEG system is in question'''''
 +
|-
 +
| '''C. [[Policies and Procedures#EEG Gain Calibration|EEG Gain Calibration]]''' || '''''-EEG results are uncertain'''''
 +
|}
  
::::::g. If hands are visibly soiled they must be washed using soap and water.
+
Reference:
 +
1. MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
  
  
::::'''V.  When to Clean Hands:'''
+
<br>
::::::•  At reporting to work (at the beginning of your shift);
 
  
::::::•  At the beginning and end of each MEG scan;
+
==== '''MEG Noise Collection''' ====
  
::::::•  Before and after subject/patient contact;
+
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''MEG Noise Collection'''<br>
 +
'''Policy No. 10.11'''
 +
|style="width: 650px"|
 +
'''Date: 1/03 <br>
 +
'''Reviewed: 11/03; 8/06; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
 +
<br>
 +
|-
 +
|
 +
'''Recommended By:'''<br>
 +
'''MEG Core Facility Staff'''<br>
 +
|
 +
'''Distribution: MEG Core Facility'''
 +
|-
 +
|}
  
::::::• Before and after touching high risk subjects or patients <br>(before taking care of a particularly susceptible patient – i.e., severely immuno-compromised).
+
'''Policy: '''Noise collection calibration procedures will be performed for quality assurance whenever necessary to evaluate the performance of the MEG system. Noise collection  is performed to determine the noise level of each individual channel. Data is collected with no subject and all noise sources are removed from the immediate vicinity of the MEG system.'''
  
::::::•  After contact with blood or other body fluids, secretions, or excretions.
+
<br>
 +
'''I.  <u>Procedure for acquiring data:</u>'''
  
::::::• Before donning gloves;
+
::1. Close the door to the MSR. The Magnetic Phantom should not be connected during a noise collection.
  
::::::•  After removing gloves- gloves can become perforated during use; <br>bacteria can multiply rapidly on gloved hands.
+
::2. Click” Acq Manager” (or click on the Terminal Screen and type “Acq” at the prompt line; then go to step# 6.)
 +
::::a. Click on “Select User”.
  
::::::•  After touching objects that are likely to be contaminated with microorganisms <br>(e.g., equipment or other items, keyboards, telephones, doorknobs, stair banister, etc.
+
::3. Select “meglab”.
  
::::::•  After applying or adjusting electrodes.
+
::4. Click on “Launch Acq”.
  
::::::•  After removing electrodes and cleaning hair and scalp.
+
::5. Select the study type: “Noise”.
 +
::::a. Click on “Ok”.
  
::::::•  After handling electrodes for cleaning or after disinfecting.
+
::6. At the Acq Window:
 +
::::a. Click on “Acquire data”.
  
::::::•  Before and after eating.
+
::7. Create Directory? Select “Ok”.
 +
::::::(If this is the first recording of the day you will need to create a directory)
  
::::::•  Whenever hands are soiled;
+
::8. At the Acquisition Monitor Window adjust the scale.
  
::::::• After going to the bathroom.
+
::9. Click on Start. There are 10 -10 sec trials.
  
::::::•  After blowing or wiping nose, coughing or sneezing.
+
::10. When the collection is done click “Ok” at the “General Information Window”.
  
 +
 +
'''II. <u>Procedure for Plotting the Data:</u>'''
 +
::1. At the "General Information Window" click on "Tools".
  
References:
+
::2. Click on DataEditor.
::1.  Refer to the CC Handwashing Policy.
 
::2. National Institute of Health, Clinical Center Hospital Epidemiology Service (HES); http://intranet.cc.nih.gov/hospitalepidemiology/ .
 
::3.  OSHA Infection Control Guidelines; www.osha.gov
 
::4.  CDC Infection Control Guidelines: www.cdc.gov
 
  
 +
::3. Click on Set.
 +
::::a. Select “MEG Left+ZF ZO” channel array.
  
 +
::4. Frequency Spectrum Display icon.
 +
::::a. Display.
 +
::::b. Trial.
 +
::::c. Stack all trials.
  
<div align="center">______________________________________________________________________________________________________________________________ </div>
+
::5. Change y axis to “5f to 10f”.  Hit Enter.
 +
 
 +
::6. List channels that have increased power on the Daily Log.
 +
 
 +
::9. Click on Set.
 +
::::a. Select” MEG Right+ZC ZP” channel array.
 +
 
 +
::10. Frequency Spectrum Display icon.
 +
::::a. Display.
 +
::::b. Trial.
 +
::::c. Stack all trials.
  
 +
::11. List channels that have increased power on log.
  
 
<br>
 
<br>
  
===='''Cleaning, Disinfection & Sterilization of MEG Equipment 9.30'''====
+
==== '''Head Coil Calibration''' ====
 +
 
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 2,370: Line 2,517:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Cleaning, Disinfection & Sterilization of MEG Equipment'''<br>
+
'''Head Coil Calibration'''<br>
'''Policy No. 9.30'''
+
'''Policy No. 10.12'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 11/03; Reviewed: 12/03; Revised: 8/06; 7/07; 3/09;  Reviewed: 4/10; 5/11; 6/12; 7/14; 1/15; Revised: 2/18'''<br>
+
'''Revised: 11/03; 8/06; 11/08; Reviewed: 1/12; 1/15; 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 2,384: Line 2,531:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: In order to interrupt the spread of infection at the point of transmission between sources and host: 1) all non-disposable equipment will be properly cleaned, <br>disinfected and/or sterilized between uses and, 2) all single use equipment will be properly disposed.'''
+
 
 +
'''Policy: Head Coil Calibration will be performed for quality assurance as part of the maintenance and calibration procedures whenever: 1) necessary to evaluate the performance of the head coil, 2) a head coil is replaced or to evaluate the performance of the MEG system.'''  
  
 
<br>
 
<br>
'''The MEG Core Facility is in compliance with all categories of isolation and specifications as mandated by the Clinical Center. All MEG Users / Research Assistants are required <br>to take the CC annual Infection  Control / Universal Precautions Training. Each User / Research Assistant will be responsible for compliance with all MEG lab Infection Control <br>policies and procedures.  All MEG Users / Research Assistants  using electrodes and / or cap applications will be trained by the MEG technologist regarding specific MEG Lab <br>Infection Control policies and procedures.'''
+
'''<u> Two Point Calibration Head Coil Calibration using the Magnetic Phantom</u>'''
 +
Each coil is placed in two positions on the lower calibration ring of the Magnetic Phantom.   Two recordings are collected with the 3 or 4 head coils positioned on the calibration ring to determine the magnetic dipole moments of the head localization coils.
  
 +
::'''I. <u>Head Coil Setup:</u>'''
 +
::::1. Fasten the Head Coils to the calibration points located on the outside surface of the Dewar using the white plastic screws. Plug the other ends into MEG jack box. Head coils are placed as usual with:
 +
::::::a. The red coil affixed to the right calibration point (if facing the dewar; your left),
 +
::::::b. The green coil attached to the left side,
 +
::::::c. The blue in the mid front and
 +
::::::d. The yellow (spare) mid back.
  
'''I. <u>PERSONAL PROTECTIVE EQUIPMENT</u>'''
+
<br>
:Personal Protective Equipment (PPE) -gloves, gown, plastic apron, masks, protective goggles and impervious barrier will be used, if transfer, aerosolization <br>or splattering of particulate matter is likely to occur. *If items are visibly soiled dispose of in a Medical Pathological Waste (MPW) Box otherwise disposed in the trash.
+
::'''II. <u>Calibration Program:</u>'''
 
+
::::1. Open a Terminal window.  
::::'''•  Gloves will be used when:'''
+
::::::a. Type: su meg (lowercase).   
::::::-  Abrading skin,
+
::::::b. Enter password: “omega2000”.
::::::-  Cleaning, disinfecting or handling equipment used on abraded skin,
+
::::::c. Enter: “calibrateCoils”.
::::::-  Handling all soiled instruments and equipment,
 
::::::-  In contact with a patient/subject with a known infectious disease,
 
::::::-  In accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.
 
 
 
 
 
::::'''• Protective Impervious Barrier will be used when:''' -
 
::::::-Abrading the skin  the physical work area surface will be partially covered with a barrier which will be used to place “contaminated/used” equipment or supplies, i.e.  
 
::::::- To place any item considered contaminated if needed for additional use otherwise if disposable the item should be disposed of in the trashcan or if <br>non-disposable cleaned using a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol,
 
::::::-  To place all soiled instruments and equipment,
 
::::::-  To place items that have come in contact with a patient/subject with a known infectious disease,
 
::::::-  In accordance with Universal / Standard Precautions, Transmission Based Precautions and CC Infection Control guidelines.
 
 
 
  
 
<br>
 
<br>
'''II.  <u>NON-PORTABLE  NON-DISPOSABLE / REUSABLE EQUIPMENT</u>'''   
+
::'''III.  <u>Calibration Procedures:</u>'''   
:'''A. ROUTINE CLEANING PROCEDURE'''
+
::::1. Type “calibrateCoils” at a command line prompt <br>(or click on the calibrateCoils icon on the desktop).  
::All Non-Disposable Immobile or Non-Immersable equipment that comes in contact with a subject/patient will be routinely cleaned by the person(s) conducting the MEG scan <br>(each User/Research Assistant) using a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl alcohol or isopropyl alcohol after each subject/patient use.   
+
::::2. Verify the head localization parameter file.
 
+
::::3. Hit ENTER if correct.  (MO15_1609.hz.rp)  
:::::::{| class="wikitable"
+
::::4. Hit ENTER to backup the current head localization parameter (rp) file and verify serial numbers.         
|-
+
::::5. Do you want to calibrate the ADC? Enter: “YES”.
| Materials Required: || Gloves, a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.
+
::::6. DSQ Electronics Setup menu displays.
|-
+
::::7. Calibrate the ADC units used to apply signals to the head localization coils.
| Responsibility: || Each User / Research Assistant
+
::::::a. Click on Channel Selector - right arrow. Start @ ADC 15. (calibrate each ADC individually; there are 16 ADC’s)
|-
+
::::::b. Click on Start Collection.
| Frequency: || After each use.
 
|}
 
  
:::::::::::::'''''*Dispose of gloves in the trash after use; if visibly soiled, dispose in an MPW box.'''''
+
::::8. Click on File.
 +
::::9. Exit.
 +
::::10. Do you want to enter coil frequencies manually?  Enter Y for yes.
 +
::::11. To accept frequency values for coils hit ENTER.
  
 +
<br>
 +
::'''IV. <u>Starting Data Collection #1</u>
 +
::::1. Hit ENTER to launch Acq to start Data Collection #1.
 +
::::2. Hit ENTER to select turn reference channels off. 
 +
::::3. Once Acq has started click on Acquire Data.
 +
::::4. At the Question Menu click Yes.
 +
::::5. Click OK for the folder name if asked.
 +
::::6. Decrease scale.
 +
::::7. When data starts scrolling across the screen, click on the Start button. 
 +
::::8. When the window appears indicating that trial #1 has been collected, click the OK button. 
 +
::::9. Select Close Window menu item from the File Menu. 
 +
:::10. Select Exit from the File Menu. 
 +
:::11. When Acq exits, hit the ENTER <Y> key to verify the data set collected.
  
:'''B. KNOWN INFECTIOUS DISEASE PROCEDURE'''  
+
<br>
::Most EEG/MEG equipment (other than electrodes and caps) usually pose no significant hazard of infection transmission, however, when used by a patient with a known <br>infectious disease the equipment will be disinfected in compliance with Transmission Based Precautions by each User/Research Assistant after each subject/patient use.
+
::'''V. <u>Starting Data Collection #2</u>'''
 +
::::1. Swap the head coils for the second data collection:
 +
::::::a. Swap the left  (green) with the right (red) head coil;
 +
::::::b. Swap the front (blue) with the back (yellow) head coil.
  
 
+
::::2. Hit ENTER to launch Acq for Data Collection #2.
:::::::::{| class="wikitable"
+
::::::a. Hit ENTER to select turn reference channels off. 
 +
::::::b. Once Acq has started click on Acquire Data.
 +
::::::c. At the Question Menu click “Yes”.
 +
::::::d. Decrease scale.
 +
::::::e. When the window appears indicating that trial #2 has been collected, click the OK    button.
 +
::::::f. Select Close Window menu item from the File Menu. 
 +
::::::g. Select Exit from the File Menu. 
 +
::::::h. When Acq exits, hit the ENTER <Y> key to verify the data set collected.
 +
 
 +
::::3. The distance between configurations #1 and #2 for each coil will be calculated and displayed. Hit ENTER to accept the distance. 
 +
:::::::::::::::{| class="wikitable"
 
|-
 
|-
| Materials Required: || Gloves, Prepping (Blue) Pad, Disposable Wash Cloth, a hospital approved disinfectant <br>such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.
+
| '''''Note: The distance should be 51.49 cm for the Omega-275 System.'''''
|-
 
| Responsibility: || Each User / Research Assistant
 
|-
 
| Frequency: || After each use.
 
 
|}
 
|}
  
:::::::::::::::'''''*Dispose of gloves and other PPE in an MPW box.'''''
+
::::4. The moments will be calculated for each coil and displayed. Hit ENTER to accept these values.
  
 
+
:::::::::::::{| class="wikitable"
 
 
 
 
:'''C.  TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES (Prions)'''
 
::'''Use Disposable Equipment and supplies only for transmissible spongiform encephalopathies (Creutzfeldt Jakob Disease, Variant Creutzfeldt Jakob Disease, <br>Fatal Familial Insomnia, Gerstmann-Straussler-Scheinker Syndrome, Kuru).  Any Portable Disposable or Non-Disposable items used on a patient with Transmissible <br>Spongiform Encephalopathies will be double bagged and sent for gas sterilization and then discarded. *Contact the Department of Perioperative Medicine <br>and Laboratory of Pathology, and also Hospital Epidemiology Service for further instructions and to make arrangements in advance.'''
 
 
 
<br>
 
::'''Usually Non-Disposable Immobile or Non-Immersable equipment (i.e., the MEG machine, chair or bed) would not come into direct contact with a patient who has <br>Creutzfeldt Jakob or other transmissible spongiform encephalopathies (prions). Any Immobile Non-Disposable Equipment used in the presence of Creutzfeldt Jakob <br>or other transmissible spongiform encephalopathies (prions) will be wiped down with a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl <br>or isopropyl alcohol. *Contact the Department of Perioperative Medicine and Laboratory of Pathology, and also Hospital Epidemiology Service for further instructions.'''
 
 
 
 
 
:::::::::{| class="wikitable"
 
 
|-
 
|-
| Materials Required: || Gloves, Prepping (Blue) Pad, Disposable Wash Cloth, a hospital approved disinfectant <br>such as Hydrogen Peroxide, 70-90% ethyl or isopropyl alcohol.
+
| '''''Note: a typical coil moment is 1.7e+11 to 1.8e+11 (fT*cm3)/A. Our range is: 1.6e+11 to 1.8e+11.'''''
|-
 
| Responsibility: || Each User / Research Assistant
 
|-
 
| Frequency: || After each use.
 
 
|}
 
|}
  
:::::::::'''''*Double bag all used items and place in an MPW box then contact the Department of Laboratory <br>Medicine to arrange gas sterilization and disposal.Dispose of gloves and other PPE in the MPW box.'''''
+
::::5. Hit RETURN to launch Acq (writes values into the parameter (rp) file).
  
 +
::::6. At the Question “Do you want to use these values/”, click “Yes” or hit the Enter key to accept the results.
  
<br>
+
::::7At the prompt “Remove calibration results datasets” hit RETURN to remove.
'''III.  <u>PORTABLE  NON-DISPOSABLE / RE-USABLE EQUIPMENT</u>'''
 
:'''A.  ROUTINE PROCEDURE FOR EQUIPMENT USED ON ABRADED SKIN'''
 
::All non-disposable electrodes, EEG Caps that comes in contact with skin that has been abraded will be considered “contaminated”This equipment will be <br>handled / processed by the User/Research Assistant conducting the scan utilizing Standard/ Universal Precautions and placed in the appropriate Biohazard Transport Container. <br>MEG staff will transport the equipment to Central Hospital Supply (CHS) for disinfection / sterilization.'''
 
  
 +
::::8.  Perform a [[Policies and Procedures#Magnetic Phantom Measurement| phantom dipole test]] to verify the new calibration moments.
  
 
<br>
 
<br>
::'''1.  ELECTRODE PROCESSING''' - Easy Cap Silver/Silver Chloride Disc Electrodes, Gereonics Silver /Silver Chloride Electrodes, IVM Slim-Trode Silver /Silver Chloride Pellet Electrodes. 
 
  
<br>
+
==== '''Magnetic Phantom Measurement ''' ====
:::::::::{| class="wikitable"
+
 
|-
+
'''National Institute of Mental Health'''
| Materials Required: || Gloves, Prepping (Blue) Pad, Disposable Wash Cloth,  Biohazard Transport Container, <br>Zip Lock Specimen Bag, Steam /Gas Sterilization Request Form, <br>a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.
+
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''Magnetic Phantom Measurement'''<br>
 +
'''Policy No. 10.13'''
 +
|style="width: 650px"|
 +
'''Date: 1/03 <br>
 +
'''Reviewed: 11/03; 8/06; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
 +
<br>
 
|-
 
|-
| Responsibility: || Each User / Research Assistant
+
|  
|-
+
'''Recommended By:'''<br>
| Frequency: || After each use
+
'''MEG Core Facility Staff'''<br>
 +
|  
 +
'''Distribution: MEG Core Facility'''
 
|-
 
|-
| Transport to CHS: || MEG Staff
 
 
|}
 
|}
  
<br>
+
'''Policy: Magnetic Phantom procedures are performed for quality assurance whenever necessary to evaluate the performance of the MEG systemMagnetic Phantom Dipole Localization is used to confirm the localization accuracy of the system by energizing a coil at a level similar to that of a brain signal and calculating its position relative to a coordinate system determined by the head localization coils.'''
::'''Procedure:'''
 
::::a.  Wash hands.
 
::::b.  Don gloves.
 
::::c.  Place the disk end of the ELECTRODE in the zippered compartment of the double pocket plastic Specimen Bag<br>Tuck the cable (pin) end of the electrode in the un-zippered compartment.
 
::::d.  Place the plastic specimen bag containing the electrodes in the top tray of the three (3) piece amber OSHA approved BIOHAZARD CONTAINER.
 
::::e.  Discard the used/” contaminated” gloves in the trash unless visibly contaminated.
 
::::f.  Wash hands after removing gloves.
 
::::g.  Place the lid on the BIOHAZARD CONTAINER.
 
::::h.  Place the BIOHAZARD CONTAINER with the soiled used/” contaminated” electrodes on the top shelf of the CHS cart.
 
::::i.  Fill out a STEAM / GAS STERILIZATION REQUEST FORM.  Indicate item quantity and the date.  The Requester is “MEG”. <br>The User/Research Assistant filling out the request should sign their name in the section entitled Requester’s Signature.
 
::::j.  Place the Request Form on top of the lid of the closed BIOHAZARD CONTAINER.
 
::::k.  Wipe the Prep Table with
 
::::l.  MEG Core staff will be responsible for transporting the BIOHAZARD CONTAINER to Central Hospital Supply for disinfection/sterilization.
 
  
 +
'''I. Magnetic Phantom Setup:'''
 +
::1. Place the platform board on the MEG chair under the Dewar.
  
<br>
+
::2. Position the Magnetic Phantom (the one with the flat white top) on platformThe energizing cable should be right of center and the Blue Head Coil center.
::'''2.  EASY CAP PROCESSING'''
 
  
<br>
+
::3. Connect the 3 head coils (Red –right; Green –left; Blue –center) to the magnetic phantom. 
  
:::::::::{| class="wikitable"
+
::4. Plug the energizing cable from the phantom into the MEG jack box spare slot.  
|-
 
| Materials Required: || Gloves, Prepping (Blue) Pad, Disposable Wash Cloth, Biohazard Transport Container, <br>Zip Lock Specimen Bag, Steam /Gas Sterilization Request Form, <br>a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.
 
|-
 
| Processing Responsibility: || Each User /  Research Assistant.
 
|-
 
| Transport to CHS: || MEG Staff /
 
|-
 
| Frequency: || After each use.
 
|}
 
 
 
 
<br>
 
  
::'''Procedure:'''
+
::5. Raise chair so that the phantom is under the helmet.
::::a. Wash hands.
 
::::b.  Don gloves.
 
::::c.  Place the CAP in the top tray of the three (3) piece amber OSHA approved BIOHAZARD CONTAINER.
 
::::d.  Discard the used/ “contaminated” gloves in the trash unless visibly contaminated. <br>All disposable items that are visibly contaminated with blood or body fluids will be disposed of in an MPW Box.
 
::::e.  Wash hands after removing gloves.
 
::::f.  Place the lid on the Biohazard Container.
 
::::g.  Place the Biohazard Container with the soiled used/” contaminated” cap on the top shelf of the CHS cart.
 
::::h.  Fill out a STEAM / GAS STERILIZATION REQUEST FORM.  Indicate item, quantity and the date.  <br>The Requester is the “MEG Core Facility” and the User/Research Assistant filling out the request <br>should sign their name in the section entitled Requester’s Signature.
 
::::i.  Place the Request Form on the top of the lid of the closed Biohazard Container.
 
::::j.  MEG staff will be responsible for transporting Biohazard Container to Central Sterile Supply.
 
  
 +
::6. Position all the cables so that they hang straight down and do not touch each other.
  
  
<br>
+
'''II. Running the Calibrate Program from the ACQ Computer:'''
 +
::1. Type “Acq”.
  
:'''B.  ROUTINE PROCEDURE FOR EQUIPMENT USED ON UN-ABRADED SKIN'''
+
::2. Select Study Type “Calibrate”.
::'''All Portable Non-Disposable equipment, i.e., head localization coils, that comes in contact with un-abraded and otherwise intact skin (including sweat) <br>will be cleaned using a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl alcohol or isopropyl alcohol.'''
 
 
<br>
 
:::::::::{| class="wikitable"
 
|-
 
| Materials Required: || 70-90% Ethyl Alcohol, Isopropyl Alcohol, Alcohol Prep Pads, and gloves
 
|-
 
| Responsibility: || Each User / Research Assistant
 
|-
 
| Frequency: || After each use
 
|-
 
| Transport to CHS: || MEG Staff
 
|}
 
  
<br>
+
::3. Select Magnetic Phantom.
::'''1. MEG HEAD LOCALIZATION COILS CLEANING'''
 
  
::'''Procedure:'''
+
::4. Might get an error message hereSelect NO.
::::a. Wash hands.
 
::::b.  Wipe the Head Localization Coils with alcohol.
 
::::c.  Adhesive Remover may be used occasionally to remove any adhesive buildup or sticky residue.
 
::::dWash hands.
 
  
 +
::5. Acquire data.
  
 +
::6. Click on Localize Head.
  
:'''C. KNOWN INFECTIOUS DISEASE (Abraded Skin or Un-Abraded Skin)'''
+
::7. OK to start localization.
::'''All Portable Non-Disposable / Reusable Equipment used by a patient with a known infectious disease will be sent to CHS for disinfection /sterilization; the only exception is for <br>Transmissible Spongiform Encephalopathies (Creutzfeldt-jakob Disease, Variant Creutzfeldt-jakob Disease, Fatal Familial Insomnia, Gerstmann-Staussler-Scheinker <br>Syndrome, and Kuru).  If possible, use only disposable equipment and supplies.'''
 
  
<br>
+
::8. Continue.
:::::::::{| class="wikitable"
+
 
|-
+
::9. Start.
| Materials Required: || Gloves, Prepping (Blue Pad), Disposable Wash Cloth, Biohazard Transport Container, <br>Zip Lock Specimen Bag, Steam / Gas Sterilization Form, <br>a hospital approved disinfectant such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.  
 
|-
 
| Responsibility: || Each User / Research Assistant
 
|-
 
| Frequency: || After each use
 
|-
 
| Transport to CHS: || MEG Staff
 
|}
 
  
<br>
+
::10. Click on Continue.
:'''Processing Procedure:'''
 
::::a.  Wash hands.
 
::::b.  Don gloves.
 
::::c.  Place the disk end of the ELECTRODE in the zippered compartment of the double pocket plastic Specimen Bag.  <br>Tuck the cable (pin) end of the electrode in the un-zippered compartment.
 
::::d.  Place the plastic specimen bag containing the electrodes in the top tray of the three (3) piece amber OSHA approved BIOHAZARD CONTAINER.
 
::::e.  Discard the used/” contaminated” gloves and other disposable used supplies in an MPW Box.  Follow the specific guidelines for the Transmission Based Precautions.  <br>All disposable items that are visibly contaminated with blood or body fluids will be disposed of in an MPW Box.
 
::::f.  Wash hands after removing gloves.
 
::::g.  Place the lid on the Biohazard Container.
 
::::h.  Place the Biohazard Container with the soiled used/” contaminated” electrodes on the top shelf of the CHS cart.
 
::::i.  Fill out a STEAM / GAS STERILIZATION REQUEST FORM.  Indicate item quantity and the date.  The Requester is “MEG”. <br>The User/Research Assistant filling out the request should sign their name in the section entitled Requester’s Signature.
 
::::j. Place the form on top of the lid of the closed Biohazard Container.
 
::::k.  MEG Core staff will be responsible for transporting the Biohazard Container to Central Hospital Supply for disinfection / sterilization.
 
  
 +
::11. Click on OK.
  
<br>
+
::12. Tools menu.  Data EditorSelect a set of channels. Expand scaleDrag to pick (pick peak with bar).  Display map to check (Select Topograph).
:'''DTRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES (Prions)'''
 
:'''Use only Disposable / Single Use equipment, if possiblePortable equipment that has been exposed to or used in the presence of Creutzfeldt Jakob or other transmissible spongiform <br>encephalopathies (prions) must be immediately placed in a sterilization bag (double bagged) and sent for gas sterilization and then discardedThe bag should be properly labeled <br>indicating the infectious agent, method of sterilization and final disposition of the contents.  *Contact the Department of Perioperative Medicine and <br>Laboratory of Pathology and Hospital Epidemiology Service to make arrangements in advance.'''
 
  
<br>
+
::13. To perform calculation -  Select Tools; Magnetic Dipole Fit; Display LaunchApp.
:::::::::{| class="wikitable"
+
 
 +
:::::::::::::::::::{| class="wikitable"
 
|-
 
|-
| Materials Required: || Gloves, Prepping (Blue Pad), Disposable Wash Cloth, Biohazard Transport Container, <br>Zip Lock Specimen Bag (2), Steam / Gas Sterilization Form, <br>Contents/ Warning Label, Marker, MPW Box, and a hospital approved <br>disinfectant such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.  
+
|'''''Report if fit error is > 2 - 2.5 mm.'''''
|-
 
| Responsibility: || Each User / Research Assistant
 
|-
 
| Frequency: || After each use
 
|-
 
| Transport to CHS: || MEG Staff
 
 
|}
 
|}
  
<br>
+
::14. Magnetic Dipole Fit
:'''Procedure:'''
 
::::1.  Wash hands;
 
::::2.  Double glove;
 
::::3.  Immediately place in a sterilization bag (double bagged); place bag in an MPW Box for transport;
 
::::4.  Discard gloves in an MPW box;
 
::::5.  Wash hands;
 
::::6.  Label the bag indicating the:
 
::::::a)  Infectious Agent,
 
::::::b)  The department to which the items / bag is going;
 
::::::c)  Method of Sterilization - Gas, and
 
::::::d)  Method of Final Disposition - Contents to be immediately discarded;
 
::::7.  Place the bag in an MPW Box and contact the appropriate department regarding instructions for transport;
 
::::8.  Don gloves; clean all surface areas with Dispatch;
 
::::9.  Wash hands.
 
  
 +
::15. Position should be 0, 0, and 0 .05
  
<br>
+
::16. File. Exit.
  
:'''IV. <u>DISPOSABLE / SINGLE USE EQUIPMENT</u>'''
+
::17. File. Close Window.
::'''Disposable only; single use equipment will not be re-used.'''
 
  
::'''A. Routine Procedure for Single Use Equipment used on Abraded Skin'''
+
::18. Exit Acq.
::::All Disposable / Single Use Equipment used abraded skin will be disposed of in the trash.  Gloves will be used when abrading the skin.  
 
  
:::::::::::::::::::{| class="wikitable"
 
|-
 
| Materials Required: || Gloves.
 
|-
 
| Responsibility: || Each User / Research Assistant.
 
|-
 
| Frequency: || After each use.
 
|}
 
  
  
<br>
+
<br>
::'''B.  Routine Procedure for Single Use Equipment used on Un-Abraded Skin'''
 
:::'''All Disposable / Single Use Equipment that is used on un-abraded skin will be disposed of in the '''<u>trash</u>''' by each user / Research Assistant after each use.''' 
 
 
 
  
 +
==== '''EEG Gain Calibration ''' ====
 +
'''National Institute of Mental Health'''
 +
{| class="wikitable"
 +
|style="width: 350px"|
 +
'''Subject:'''<br>
 +
'''MEG Core Facility'''<br>
 +
'''EEG Gain Calibration Procedures'''<br>
 +
'''Policy No. 10.14'''
 +
|style="width: 650px"|
 +
'''Date: 1/03 <br>
 +
'''Reviewed: 11/03; 8/06; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
 
<br>
 
<br>
::'''C.  Known Infectious Disease (Single Use Equipment)'''
 
:::'''All Disposable / Single Use Equipment used by a patient with a known infectious disease must be disposed of in a '''<u>Medical Pathological Waste (MPW) Box</u>'''.
 
 
::::::::::::::{| class="wikitable"
 
 
|-
 
|-
| Materials Required: || Gloves, Prepping (Blue) Pad, MPW Box, and a hospital approved disinfectant <br>such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.
+
|  
|-
+
'''Recommended By:'''<br>
| Responsibility: || Each User / Research Assistant / MEG Technologist.
+
'''MEG Core Facility Staff'''<br>
 +
|  
 +
'''Distribution: MEG Core Facility'''
 
|-
 
|-
| Frequency: || After each use.
 
 
|}
 
|}
 
<br>
 
 
  
:::'''D.  Transmissible Spongiform Encephalopathies (Prions)'''  
+
'''Policy: EEG Calibration procedures will be performed for quality assurance whenever necessary to evaluate the performance of the MEG / EEG system and / or if <br>EEG results are in doubt.'''
::::'''Disposable / Single Use Equipment and other materials or equipment that has been exposed to or used in the presence of Creutzfeldt Jakob or other transmissible spongiform <br>encephalopathies (prions) must be immediately placed in a sterilization bag (double bagged) and sent for gas sterilization and then discarded.  The bag should be properly <br>labeled indicating the infectious agent, method of sterilization and final disposition of the contents. *Contact the Department of Perioperative Medicine and Laboratory of Pathology and <br>Hospital Epidemiology Service to make arrangements in advance.'''
 
  
 
:::::::::::{| class="wikitable"
 
|-
 
| Materials Required: || Gloves, Prepping (Blue) Pad, Disposable Wash Cloth, Sterilization Bag (2), <br>Contents / Warning Label, Marker, MPW Box, and a hospital approved <br>disinfectant such as Hydrogen Peroxide, 70-90% ethyl or,/isopropyl alcohol.
 
|-
 
| Responsibility: || Each User / Research Assistant / MEG Technologist.
 
|-
 
| Frequency: || After each use.
 
|}
 
 
 
 
<br>
 
 
'''Procedure:'''
 
'''Procedure:'''
::1. Wash hands; double glove;
+
::1.Touch the gold static button before removing the head box and before inserting the shorting plug.
::2.  Immediately place in a sterilization bag (double bagged);
 
::3.  Discard gloves in an MPW box; wash hands;
 
::4.  The bag should be properly labeled indicating the:
 
::::a)  Infectious Agent,
 
::::b) Department to which the items / bag is going,
 
::::c)  Method of Sterilization - Gas Sterilization and
 
::::d)  Method of Final Disposition - Contents to be immediately discarded;
 
::5.  Send sterilization bag with contaminated equipment for gas sterilization and final disposition of the contents as instructed;
 
::6.  Don gloves;
 
::7.  Clean all surface areas with Dispatch;
 
::8.  Wash hands.
 
 
  
'''Adverse Occurrences:'''
+
::2.If applicable, remove the EEG jack box.   
::1Exposure to an infectious agent.
 
  
'''Course of Action for Adverse Occurrence:'''
+
::3.Mount the green EEG Gain Calibration Card (also called the Shorting Plug) on the amplifier.
::1. Follow the Clinical Center Infection Control Guidelines in accordance with the specific kind of exposure.
 
::2.  Report to Occupational Medical Service (OMS).
 
::3.  Fill out a MEG Variance Report.
 
  
 +
::4. Run Acq for EEG calibration.
 +
::::a. Select - Calibrate.
 +
::::b. Select - EEG.calib
  
 +
::5. At the query “Would you like to save the protocol as the default for the study?” enter NO.
  
 +
::6. Click on the WINDOWS menu.
  
<br>
+
::7. EEG channel (highlight 64 EEG channels).
'''References:'''
 
::1.  National Institute of Health, Clinical Center Hospital Epidemiology Service: http://intranet.cc.nih.gov/hospitalepidemiology/ .
 
::2.  OSHA Infection Control Guidelines: www.osha.gov .
 
::3.  CDC Infection Control Guidelines; www.cdc.gov /
 
  
 +
::8. Select Null Offset.
  
 +
::9. Select Cal gain.
  
<br>
+
::10. At Warning click OK.
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
 
  
 +
::11. Save.
  
<br>
+
::12. Exit Acq; NO (do not save rp file).
  
===='''Infection Control - EEG Caps & Electrodes 9.40'''====
+
::13. Dsqsetup (To write values to the database).
'''National Institute of Mental Health'''
+
 
 +
::14. File.
 +
 
 +
::15. Save as:  Type (“today’s date”. rack).
 +
 
 +
::16. Click OK.
 +
 
 +
::17. Select Exit.
 +
 
 +
::18. Record Values in the database. Type “. /recordcaib.py –w” (write to database). 
 +
::::::::::::::::::::{| class="wikitable"
 +
|-
 +
| '''''The gain corrections are typically 1.0 + 2%.'''''
 +
|}
 +
 
 +
 
 +
 
 +
References:
 +
1. MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
 +
 
 +
<br>
 +
 
 +
==== '''MEG Lab System Monitors ''' ====
 +
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
 
|style="width: 350px"|
 
|style="width: 350px"|
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Infection Control - EEG Caps & Electrodes'''<br>
+
'''MEG Lab System Monitors'''<br>
'''Policy No. 9.40'''
+
'''Policy No. 10.15'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 2/18; Revised: 2/18'''<br>
+
'''Revised: 8/06; 11/08; 8/09; Reviewed: 1/12; 1/15; Revised: 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 2,739: Line 2,799:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: All non-disposable EEG caps and electrodes that come in contact with skin that has been abraded will be considered “contaminated”. Non-disposable electrodes <br>and EEG caps will be sent to Hospital Environmental Services (HES) for disinfection / sterilization. *With the exception of the VSM Easycap which will be transported to the <br>NINDS EEG Department for disinfection as per specific manufacturer’s instructions as outlined in P&P 9.45.'''
 
  
<br>
+
'''Policy: MEG System Monitors evaluate the performance and integrity of the MEG equipment for quality assurance.   
:::::::::{| class="wikitable"
 
|-
 
| Materials Required: || Gloves, Prepping (Blue Pad), Disposable Wash Cloth, Biohazard Transport Container, <br>Zip Lock Specimen Bag (2), Steam / Gas Sterilization Request Form, <br>Contents/ Warning Label, Marker, MPW Box, and a hospital approved <br>disinfectant such as Hydrogen Peroxide, 70-90% ethyl or isopropyl alcohol.  
 
|-
 
| Responsibility: || Each User / Research Assistant
 
|-
 
| Frequency: || After each use
 
|-
 
| Transport to CHS: || MEG Staff
 
|}
 
  
 
<br>
 
<br>
 +
::'''Procedure:'''
  
'''Procedure:'''
+
::'''I.  Oxygen Monitor Level Check:'''
  
::'''INON-DISPOSABLE ELECTRODE(S) – e.g., Silver/Silver Chloride Disc Electrodes, Gereonics Silver /Silver Chloride Electrodes, Grass Gold Electrodes'''
+
::::1AirPure Oxygen Monitor
 +
::::::•  located in the MEG Lab on the wall just outside the MSR (Magnetically Shielded Room);
 +
::::::•  measures the percentage of oxygen (O2) in the MEG lab;
 +
::::::•  this may be an indication of the air exchange in the MSR and/or the general integrity of the Dewar and related equipment.
  
::::1Latex rubber gloves must be use whenever handling and/or processing electrodes used on abraded skin.  For individuals sensitive to latex, nitrile rubber gloves may be used.
+
::::2Check the monitor and record the readings on the QA / Maintenance Log.
  
::::2Place the disk end of the electrode in the zippered section of the 2-pocket zip lock plastic bag.
+
::::3The O2 level should be at about 20.9%.
 +
::::::•  the normal range is 19.5-22%;
 +
::::::•  a reading of 22.0% indicates an oxygen enriched atmosphere which can promote fires (burning);
 +
::::::•  a reading of 19.5 or less indicates an oxygen deficient atmosphere and can lead to a loss of consciousness and/or asphyxiation.
  
::::3Place the wire end in the un-zippered pocket of the zip lock plastic bag.
+
::::4The alarm will sound if this level decreased below a certain set level; if that happens:
 +
::::::•  open the door to the MSR and both doors to the lab;
 +
::::::•  evacuate lab if necessary;
 +
::::::•  notify the staff scientist or lab director immediately.
 +
<br>
 +
::'''II.  He Gas Flow Meter Readings:'''
  
::::4Place the plastic bag containing the “contaminated” electrode(s) in the top tray of the three (3) piece amber OSHA approved Biohazard Container.
+
::::1The Gilmont Gas Flow Meter
 +
::::::•  located inside the MSR near the back-left wall;
 +
::::::•  monitors the rate of Helium boil off which gives an indication of the general integrity of the MEG Dewar and related equipment.
  
::::5Place the lid on the Biohazard Container.
+
::::2Check and record the reading on the QA / Maintenance Log.
  
::::6Place the Biohazard Container on the top shelf of the Environmental Services Department (ESD) Processing Cart.
+
::::3The Gas Flow Rate Meter Sensor level fluctuates
 +
::::::•  should generally be about 28.
  
::::7Fill out a “Steam/Gas Sterilization Request Form” for each container and place the form on the top of the appropriate closed Biohazard Container.
+
::::4After a fill the flow rate might get as high as 40 (at 40 the alarm will go off), however, the level should go back down to 28 within a <br>reasonable period of time after the fill.
  
::::8MEG staff will transport the Biohazard Container to ESD for disinfection/sterilization.  
+
::::5If this reading is elevated notify the staff scientist or lab director.
 
+
<br>
::::9Biohazard Containers with “contaminated” equipment will be logged in and out per ESD procedures.
+
::'''IIILiquid Helium Level Check:'''
  
 +
::::1.  The AMI Model 135 Liquid Helium Level Monitor
 +
::::::•  located on the stand just outside the MSR;
 +
::::::•  measures the amount of helium inside the MEG Dewar;
 +
::::::•  should never be allowed to go below 0 (zero) and
 +
::::::•  should not exceed 39.0.
  
::'''IINON-DISPOSABLE EEG CAP –  e.g., Easy Cap'''
+
::::2Plug in the monitor cable.  The plug is located inside the MSR near the back-left wall.
  
::::1Latex rubber gloves must be used whenever handling and/or processing an EEG Cap that has been used on abraded skin.  For individuals sensitive to latex, <br>nitrile rubber gloves may be used.
+
::::3Check and record the reading on the QA / Maintenance Log.
  
::::2Removed all electrodes from the cap.  *The EEG Cap and electrodes will be processed separately.
+
::::4If the level is approaching 0 (zero) a liquid Helium Fill should be performed; notify appropriate lab personnel.
  
::::3Place the cap in the top tray of the three (3) piece amber OSHA approved Biohazard Container.   
+
::::5When filled the Liquid Helium Level should not exceed 39.0.   
  
::::4Place the lid on the Biohazard Container.
+
::::6If an overfill occurs:
  
::::5Place the Biohazard Container on the top shelf of the ESD processing cart.
+
::::::aNotify the staff scientist and/or lab director;
 +
::::::b.  Keep the door to the MSR open;
 +
::::::c.  Leave the Dewar at 550  for 12 to 24 hours.  
  
::::6.  Fill out the Gas Sterilization Request form and place on top of the appropriate closed container.
 
 
::::7.  MEG staff will transport the Biohazard Container to ESD for disinfection / sterilization.
 
 
 
 
'''References:'''
 
::::1.  National Institute of Health, Clinical Center Hospital Epidemiology Service (HES); http://intranet.cc.nih.gov/hospitalepidemiology/ .
 
::::2.  OSHA Infections Control Guidelines; www.osha.gov .
 
::::3.  CDC Infections Control Guidelines; www.cdc.gov .
 
 
<br>
 
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
  
  
  
 +
::'''References:'''
 +
::::1.  MEG/EEG Operation and Technical Reference Manuals, CTF Systems Inc. (www.ctf.com).
  
 
<br>
 
<br>
  
===='''VSM Easycap (Model B-VSM-0123) Electrode & Cap Maintenance, Cleaning & Disinfection 9.45'''====
+
==== '''MEG Lab Materials Safety ''' ====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 2,815: Line 2,875:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''VSM Easycap (Model B-VSM-0123) Electrode & Cap Maintenance, Cleaning & Disinfection'''<br>
+
'''Material Safety and Data Sheets '''<br>
'''Policy No. 9.45'''
+
'''Policy No. 10.20'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Reviewed: 2/18; Revised: 2/18'''<br>
+
'''Reviewed: 8/06; 11/08; 1/12; 1/15; Revised: 2/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 2,829: Line 2,889:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: The VSM EasyCap and electrodes will be cleaned and disinfected per manufactures’ instructions in the NINDS EEG Department using Cidex OPA. Cleaning / Disinfection will be performed using NIH approved chemical disinfectants according to Hospital Epidemiology Service requirements in hospital approved designated area(s) only. '''
+
 
 +
'''Policy: In compliance with OSHA and the Hazard Communication Standard, Material Safety & Data Sheets will be kept for all chemicals used in the MEG lab. The MSDS Manual will be accessible to all users and employees when in the MEG lab to ensure that the information regarding the properties, hazards, safe and appropriate uses are available for all to review.
  
 
<br>
 
<br>
'''Procedure:'''
+
::'''Procedure:'''
<br>
 
'''After each use in the MEG Lab (B1 D65B) the VSM Easycap and electrodes will be transported in a Biohazard Transport Container to the NINDS EEG Department (10 / CRC Rm 7-3753) by the NINDS EEG Department staff to be cleaned and disinfected as outlined below.'''
 
  
<br>
+
::::1. MSD Sheets on all substances / chemicals used in the MEG Core Facility will be kept in a binder located in the MEG lab at the console;
:::::::::{| class="wikitable"
 
|-
 
| Materials Required: || Gloves, Biohazard Transport Container
 
|-
 
| Responsibility: || Research Assistant / NINDS EEG Department Staff / MEG Staff.
 
|-
 
| Frequency: || After each use
 
|-
 
| Transport to NINDS for cleaning &Cidex disinfection: || Research Assistant / NINDS EEG Department Staff / MEG Staff.
 
|}
 
  
<br>
+
::::2.  The MSD Sheets will be available to all MEG users, staff and employees.
  
  
  
::'''I.  Cleaning without Detergents'''
 
  
::::'''A.  EasyCap:'''
 
::::::1.  Soak the cap for 30 sec in tap water, while observing proper Infection Control techniques, as soon as possible after use to remove any leftover gel/paste. 
 
::::::2.  Brush / clean cap with a soft toothbrush, if there is any remaining gel/paste.
 
::::::3.  Rinse the cap under running lukewarm tap water.
 
::::::4.  Disinfect the cap per manufacturer’s instructions following Hospital Epidemiology Services (HES) / MEG Lab Infection Control policies and procedures.
 
  
::::'''B.  Electrodes:'''
 
::::::1.  Brush electrodes with a soft toothbrush, while employing proper Infection Control techniques, as soon as possible after use to remove gel/paste.
 
::::::2.  Rinse electrodes under running lukewarm tap water.
 
::::::3.  Do not immerse the JIF end of the electrode assembly in water; wipe with a hospital approved cleaner or disinfectant. 
 
::::::4.  Disinfect electrodes per manufacturer’s recommendations using Metricide, Envirocide or Cidex OPA while following CCs / MEG Lab Infection Control policies and procedures.
 
:::::::::::::::'''''*Every so often after rinsing (Step# 2), soak / swish the electrodes in distilled water.'''''
 
 
 
::'''II.  Cleaning using Detergents'''
 
::'''Detergent is only necessary if the cap or electrodes have been in contact with a fatty/greasy substance such as sweat, hand cream, styling products, gel, hair oil'''
 
::'''or dirt.  Do not use DISH DETERGENTS as they leave a film on the surface of cleaned electrodes, which impedes achieving good electrode impedances later'''
 
::'''on.  Use “pure” soap or shampoo; Castile Soap or baby shampoo provide a better option.'''
 
 
::::A.  EasyCap:
 
::::::1.  Pour the detergent into a container of tap water.
 
::::::2.  Soak the cap for 30 to 60 seconds in tap water as soon as possible after use to remove any leftover gel/paste.
 
::::::3.  Brush / clean cap with a soft toothbrush, if there is any remaining gel/paste.
 
::::::4.  Rinse the cap under running lukewarm tap water.
 
::::::5.  Disinfect the cap per manufacturer’s recommendations using Metricide, Envirocide or Cidex OPA while following CCs / MEG Lab Infection Control policies and procedures.
 
 
::::B.  Electrodes:
 
::::::1.  Pour the detergent into a container of tap water.
 
::::::2.  Soak the electrodes for 30 to 60 seconds in distilled water.
 
::::::3.  Clean electrodes with a soft toothbrush as soon as possible after use to remove any remaining gel/paste.
 
::::::4.  Rinse electrodes under running lukewarm distilled water.
 
::::::5.  Disinfect electrodes per manufacturer’s recommendations using Metricide, Envirocide or Cidex OPA while following CCs / MEG Lab Infection Control policies and procedures.
 
 
 
::'''III.  Disinfection using Cidex OPA'''
 
::'''The VSM EasyCap and electrodes will be disinfected in the NINDS EEG Department by the EEG staff using Cidex OPA per manufacturer’s <br>specification and in accordance with the proper use of Cidex OPA as specified by the manufacturer and CC Infection Control policies and procedures.'''
 
             
 
 
::::'''''Please Note:'''''
 
::::::''1.  Do not leave the electrodes in water for a long period of time.''
 
::::::''2.  DO NOT EMERGE / SOAK THE ELECTRODE CONNECTOR / JIF IN WATER; wipe the JIF connector with a Clinical Center <br>approved disinfectant, such as hydrogen peroxide.''
 
::::::''3.  Do not expose the cap or electrodes to temperatures over 35 degrees.''
 
::::::''4.  Changes in surface color can be ignored.''
 
::::::''5.  Measure the continuity of electrodes using an Ohms Meter.''
 
::::::''6.  Broken or damaged individual electrodes are NOT repairable or replaceable.''                                   
 
 
 
 
::'''References:'''
 
::::1.  National Institute of Health, Clinical Center Hospital Epidemiology Service.
 
::::2.  OSHA Infection Control Guidelines.
 
::::3.  CDC Infection Control Guidelines.
 
::::4.  EasyCap Recommendations / Instructions.
 
 
 
  
  
 
<br>
 
<br>
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
<br>
 
 
 
  
===='''Drug Studies Infection Control Procedures 9.50'''====
+
==== '''Liquid Helium Safety Procedures ''' ====
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 2,922: Line 2,913:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''Drug Studies Infection Control Procedures'''<br>
+
'''Liquid Helium Gas Safety'''<br>
'''Policy No. 9.50'''
+
'''Policy No. 10.30'''
 
|style="width: 650px"|
 
|style="width: 650px"|
'''Date: 1/11 <br>
+
'''Date: 1/03 <br>
'''Revised: 1/12; 1/15; 2/18'''<br>
+
'''Reviewed: 11/03; 8/06; 11/08; Revised: 1/12; Reviewed: 1/15; Revised: 2/18; 8/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 2,933: Line 2,924:
 
'''MEG Core Facility Staff'''<br>
 
'''MEG Core Facility Staff'''<br>
 
|  
 
|  
'''Distribution: MEG Core Facility, 7NE Nursing Staff, Hospital Epidemiology Service (HES)'''
+
'''Distribution: MEG Core Facility'''
 
|-
 
|-
 
|}
 
|}
<div style="margin-left:0.0626in;margin-right:0in;"><u>'''Policy</u>: '''During an MEG scan that involves drawing blood in the MEG Lab infection control procedures must be followed. All nurses participating in drug studies / protocols must follow all MEG Lab Infection Prevention / Infection Control Policies and Procedures (9.00, 9.20, 9.30, 9.40) which are posted in the Policy & Procedures Manual located in the MEG lab and on the MEG lab website (http://kurage.nimh.nih.gov/meglab).'''
+
 
 +
'''Policy: Users of Liquid Helium will be: 1) familiar with the properties and characteristics of the gases used in the MEG Lab and, 2) knowledgeable about the operation of gas cylinders to ensure that those gases are being used, stored and transported according to NIH safety guidelines and safe laboratory practices.
 +
 
 
<br>
 
<br>
 +
::'''Procedure:'''
  
'''In addition, all nurses assisting with blood draws in the MEG lab must comply with all Clinical Center Infection Control Policies and Procedures.'''
+
::::1.  All MEG staff and users must familiarize themselves with the properties of Liquid Helium. Refer to the Material Safety and Data Sheet (MSDS) Manual.
  
 +
::::2.  The contents of Liquid Helium Storage Dewars will be identified with decals, stencils, or other markings on the outside of the Dewar.
 +
::::::a.  Color codes alone or tags hung on the outside of the Dewar are not acceptable.
 +
::::::b.  Dewars lacking proper identification must not be accepted from the vendors.
  
'''Procedures:'''
+
::::3Liquid Helium Storage Dewars are transported by using the handle to pull the Dewar; they must never be pushed. Always keep the Dewar in the upright position.
::::1All nurses participating in drug studies in the MEG Lab must attend MEG Lab specific Infection Control training.
 
 
 
::::2.  Gloves will be used when drawing blood or whenever touching the blood draw syringe or any potentially contaminated items.
 
  
::::3“Contaminated” gloves will be discarded before touching any other items in the MEG lab.
+
::::4Liquid Helium Storage Dewar will be transported with the Relief Isolation Valve open so that pressure does not build up in the storage dewar.  
  
::::4After gloves are removed, hands must be washed / sanitized before touching any other “clean” items including MEG equipment, telephone and any computer keyboards.
+
::::5The cylinder contents must be permanently attached to the outside of the Dewar.  This identification shall not be removed, covered or defaced.
  
::::5All surfaces (prep table, cabinets) will be wiped with Dispatch after use.
+
::::6Liquid Helium will not be used in environmental rooms unless there is adequate ventilation and/or an oxygen monitor with an audible alarm is present and permission has been granted by the Safety Officer.
  
::::6All MEG Lab staff will monitor participants for compliance.
+
::::7Liquid Helium will be handled using the appropriate care and protective equipment, i.e., face shield and cryogloves, as necessary because contact can cause severe frostbite. 
  
 +
::::8.  The safety warnings located on the Helium Dewar will always be followed. 
  
 +
::::9.  Empty cylinders will be marked “EMPTY”.
  
:::::::::''*Anyone who has not received MEG lab Infection Control training should contact the MEG Lab Manager as soon as possible.''
+
<div align="center">____________________________</div>
::::::::::::::''**MEG staff will monitor hand washing in compliance with the CC Hygiene Initiative.''
 
  
 +
::'''Variance Event / Quality Assurance:'''
 +
::::1.  Cylinder Leak.
  
 +
::'''Course of Action Event:'''
 +
::::1.  Cylinder Leak – if this happens
 +
::::::a.  If there are reasons to believe that a cylinder is leaking, test for the leak by painting soapy water over the valves and connections.  <br>This will indicate most gas leaks.
 +
::::::b.  Do not attempt to repair leaks caused by loose valve stem packing.
 +
::::::c.  Leaking storage Dewars of liquid helium will be moved to a well-ventilated area.  There is no potential harm if helium does not critically <br>displace the amount of oxygen. 
 +
::::::d.  The Dewar must be labeled indicating the problem. 
 +
::::::e.  The vendor will be called for pickup. 
 +
::::::f.  Assistance can be obtained from the Health and Safety Branch or by contacting the Safety Officer.
  
  
<br>
+
==== '''MEG Dewar Spontaneous Warmup Safety Procedures  ''' ====
<div align="center">______________________________________________________________________________________________________________________________ </div>
 
 
 
<br>
 
<div align="center"> ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦</div>
 
<br>
 
 
 
===<big>'''Quality Assurance / Risk Management (10.00)'''</big>===
 
 
 
==== '''QA /QI Risk Management Plan (10.00)''' ====
 
 
'''National Institute of Mental Health'''
 
'''National Institute of Mental Health'''
 
{| class="wikitable"
 
{| class="wikitable"
Line 2,978: Line 2,974:
 
'''Subject:'''<br>
 
'''Subject:'''<br>
 
'''MEG Core Facility'''<br>
 
'''MEG Core Facility'''<br>
'''QA /QI Risk Management Plan'''<br>
+
'''Liquid Helium Gas Safety'''<br>
'''Policy No. 10.00'''
+
'''Policy No. 10.30'''
 
|style="width: 650px"|
 
|style="width: 650px"|
 
'''Date: 1/03 <br>
 
'''Date: 1/03 <br>
'''Revised: 8/06; 11/08; Reviewed: 1/12; 1/15; 2/18'''<br>
+
'''Reviewed: 11/03; 8/06; 11/08; Revised: 1/12; Reviewed: 1/15; Revised: 2/18; 8/18'''<br>
 
<br>
 
<br>
 
|-
 
|-
Line 2,992: Line 2,988:
 
|-
 
|-
 
|}
 
|}
<div style="margin-left</