EMG Quality Assurance & Compliance 2 — Questions and Answers
Question 1: Which document must be completed before performing an EMG study on a patient who cannot provide verbal consent?
- Verbal consent waiver signed by the technologist
- Written informed consent from a legally authorized representative (Correct answer)
- Physician order only, no consent needed
- Post-procedure consent form
Correct answer: Written informed consent from a legally authorized representative
When a patient cannot provide verbal consent, written informed consent must be obtained from a legally authorized representative prior to the procedure.
Question 2: A needle EMG electrode is visibly bent after use. What is the correct action?
- Straighten it and re-sterilize for reuse
- Discard it in a sharps container immediately (Correct answer)
- Return it to the manufacturer for recycling
- Place it in biohazard bag for later disposal
Correct answer: Discard it in a sharps container immediately
Bent or damaged single-use needle electrodes must be immediately discarded in an approved sharps container to prevent injury and cross-contamination.
Question 3: What is the primary purpose of a daily biological check on an EMG amplifier?
- To calibrate the time base against an atomic clock standard
- To verify that the amplifier accurately records known biological signals (Correct answer)
- To reset the common mode rejection ratio to factory defaults
- To update the software firmware for new waveform templates
Correct answer: To verify that the amplifier accurately records known biological signals
A daily biological check ensures the amplifier is faithfully recording known signal characteristics, confirming instrument function before patient studies.
Question 4: Which OSHA standard most directly governs EMG laboratory personnel exposure to bloodborne pathogens?
- 29 CFR 1910.134 (Respiratory Protection)
- 29 CFR 1910.1030 (Bloodborne Pathogens Standard) (Correct answer)
- 29 CFR 1910.147 (Lockout/Tagout)
- 29 CFR 1910.303 (Electrical Safety)
Correct answer: 29 CFR 1910.1030 (Bloodborne Pathogens Standard)
OSHA 29 CFR 1910.1030, the Bloodborne Pathogens Standard, mandates exposure control plans, PPE use, and training for workers at risk of contact with blood or OPIM.
Question 5: When must a conduction velocity measurement be corrected for skin temperature in nerve conduction studies?
- Only when the patient reports feeling cold
- When limb skin temperature falls below 32°C (89.6°F) (Correct answer)
- Whenever ambient room temperature exceeds 25°C
- Temperature correction is never required per AANEM guidelines
Correct answer: When limb skin temperature falls below 32°C (89.6°F)
Nerve conduction velocities slow approximately 1.5–2.5 m/s per degree Celsius drop; correction or warming is required when skin temperature falls below 32°C to avoid falsely abnormal results.
Question 6: A quality assurance audit finds that impedance checks are not being documented. What is the most significant risk?
- Increased study duration
- Inability to verify signal quality or identify electrode failures retrospectively (Correct answer)
- Higher reimbursement denial rates from CMS
- Risk of equipment overheating
Correct answer: Inability to verify signal quality or identify electrode failures retrospectively
Without documented impedance values, there is no retrospective evidence that electrode contact quality was adequate, undermining the validity of recorded signals.
Question 7: Which accreditation body specifically offers laboratory accreditation programs relevant to EMG and nerve conduction study facilities?
- American Board of Radiology (ABR)
- The Joint Commission (TJC) only
- Intersocietal Accreditation Commission (IAC) (Correct answer)
- College of American Pathologists (CAP)
Correct answer: Intersocietal Accreditation Commission (IAC)
The Intersocietal Accreditation Commission (IAC) offers an accreditation program for neuromuscular and nerve conduction study laboratories, setting standards for equipment, personnel, and reporting.
EMG Quality Assurance & Compliance 2
Which document must be completed before performing an EMG study on a patient who cannot provide verbal consent?