It doesn't seem to matter how long you have been in the Neurodiagnostic field, it seems we all have the same issues. How do we keep the electrodes in place? This can range from short term recordings to long term recordings and ambulatory. ICU, EMU and more have their own challenges to the products we are allowed to use in different facilities and circumstances.
There are some considerations when choosing what products to use, when we use them and why. This can be situational based on the patient age and medical condition. This can also be considered for skin breakdown. What products we use are directly affecting the patient and our work flow if we have to repair or rest the patient and reapply. Here are just a few options on the market and they all have their own perks and pitfalls.
Medical Tape: I have seen this used in different ways for EEG application. Some labs I have seen use tape exclusively over their leads with 10 20. Some use tape with collodion as a way to secure the leads and then apply collodion on top.
Hypafix- This can be found in almost any hospital or clinic setting as it is versatile and used for would dressings as well as sleep studies. The down side is that it may be hard to remove from the head and or hair without causing irritation and pr discomfort to the patient.
Paper tape- This product is self explanatory. The adhesive may not be very strong which is good for the patient and removal. However it is paper and may tear or disintegrate when moistened by products or sweat.
Silk Surgical Tape- This product also has the advantage of a strong adhesive but is also stiff and usually requires scissors to cut. This also may be difficult to remove.
Medi pore surgical tape- You can get the product in perforated rolls which is nice. It is a pliable easy to use product. I have seen successful routine studies done with this tape over the electrode and is fairly easy to remove without much discomfort to the patient.
Collodion: This product is something most of us are familiar with. This is a highly flammable product that requires strict ventilation and storage guidelines.
Collodion is a great tool for long term studies and ambulatory. I have seen labs use this for routine studies as well. If you have ever been in a collodion application, you know the smell. Even the development of this product that has tried to reduce the odor, it is still unmistakable.
The perks are that it is one of the most secure methods of application when done right. It does take practice and skill to work effectively and efficiently with this product. It will dry rapidly but also requires an air source to blow dry into place. I have glued my gloves to a mannequin while learning this application technique!
The downside is the smell. It is also messy and time sensitive and this product requires a solution for removal. We have also had removal tools like baby oil or coconut oil to be less irritating to the patient than collodion remover or acetone. Both are extremely delicate to use as a removal tool so we don't allow the solution to get in the patients face or eyes.
SAC2: This product is more like a paste that dries stiff. It is water soluble and without any odor.
I have used SAC2 in application myself with gauze squares. I liked the result. With all application methods you have to practice. This can get all over the place when applying right from the tube. I used a syringe to apply to gauze then covered the electrode paste side down and smoothed over the gauze.
The downside of this application is that you need to work with it to see how it best works for you. I have never seen this product used as a stand alone adhesive. It is water soluble so it can disintegrate with moisture and sweat. It does dry to a chalky, cement like consistency so removal may take some soaking.
Tensive : This product is clear and water soluble without any odor.
Tensive is very sticky and has a little bit of drying time. So it is pliable and you have time to work while it sets. I have also used this myself and prefer to use a syringe when applying to gauze or any covering you choose. This does tend to dry to a clear covering. You can use warm water to dissolve or conditioner over the dry product and it will loosen so the electrodes can slide off without pulling hair. Because it is water soluble, it can be effected by sweat and moisture.
There are more and more products out there on the market for EEG. Some labs have found a combination of products that work for them. Weather you are looking for a new product or experimenting with different application techniques, it seems that practice is the key to success with anything we do.
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