Thymatron
®
System IV Instructions for Use
36
the channel 4 holes.
EMG: The purpose of monitoring EMG is to provide an automated and highly accurate estimate of the motor
seizure duration. Apply two monitoring electrodes spaced about 3” apart to a limb that has been cuffed to
prevent the effects of the muscle-relaxant drug. Connect the channel 3 red and black lead-wires in any order of
polarity to monitor from the patient’s arm and plug into the channel 3 holes. (Use the brown 60 inch lead-wires
to monitor from the patient’s foot, as illustrated.)
A 3-channel monitoring setup (EEG in channel 1, EMG in channel 3, and ECG in channel 4)
For the preferred left fronto-mastoid EEG configuration, place one monitoring electrode above the left eyebrow
and the other electrode over the left mastoid bone. Connect the channel 1 lead-wires to the monitoring electrodes
in any order of polarity (no splitter is used), and connect the ECG and EMG electrodes, ground electrode, and
lead-wires as described above.
For 3 or 4-channel EEG monitoring (primarily used for research) use the electrode placements of your choice,
remembering to keep the polarity (relationship of red and black lead-wires) consistent for corresponding
channels on each side of the head. If you connect the red and black lead-wires to frontal and temporal monitoring
electrodes, respectively, on the left side of the head, be sure to maintain the same polarity relationship when
connecting the corresponding pair of frontal and temporal electrodes on the right side of the head. Apply a
monitoring electrode to either shoulder as a ground and connect it to the green lead-wire clip.
CHANNELS 3 & 4 SELECTION
EEG is always monitored from channels 1 & 2 and they are not user selectable. Channels 3 & 4 can monitor
either EMG and ECG or two more channels of EEG. To select the monitoring options for channels 3 & 4, follow
the procedure below:
FlexDial™ CH 3-4 EMG-ECG; EEG-EEG
STIMULUS ELECTRODES APPLICATION
Instructions for legacy metal old type stimulus electrodes are in
Addendum VI
.
Apply Thymapad™ adherent stimulus electrodes [Cat. # EPAD] electrodes supplied with the Thymatron®
System IV according to the directions, “Use of Thymapad™ Disposable ECT Stimulus Electrodes”. Clean the
patient’s skin sites by rubbing vigorously with a saline moistened swab and pat dry. Do not use solvents (e.g.,
alcohol) with Thymapad™ stimulus electrodes. Spread 1-2 drops of Pre-Tac solution over the site and rub into
the skin with a fingertip until dry. Remove a Thymapad™ from its wrapper, peel it from the plastic backing, and
apply it firmly to the bare skin.
Insert the banana plug from the ECT stimulus cable into the plastic receptacle at the end of each Thymapad™
wire, until the entire conducting surface of each banana plug is covered and no metal shows. Press firmly again
on each Thymapad™ to ensure it is fully applied and then test the static impedance. Impedance testing is
