Control infection risks in accordance with departmental protocols

• Protocols and requirements for hygiene and infection control related to the relevant range of investigations, including preparation, conduct and completion of investigation
• Protocol for hand washing and how effective hand washing contributes to control of infection

Minimise risks and hazards in compliance with health and safety policies

• The relevant health and safety regulations specific to neurophysiology investigations, the potential hazards and risks, and the actions to be taken to minimise these

Gain informed consent for each type of investigation

• The importance of explaining the procedure for each investigation to the patient/parents/guardian and gaining informed consent
• Principles, guidance and law with respect to informed consent

Plan and prepare for the recording of a paediatric EEG

• Local Standard Operating Procedure for paediatric EEG
• The range of paediatric conditions requiring an EEG investigation
• Special needs of paediatric patients
• The referral system for paediatric EEG
• The range and types of information required and its importance
• Checking for validity of information
• Appropriate action to be taken in the event of missing or invalid information
• The purpose of paediatric EEG and its appropriateness for the conditions presented
• Assessment of appropriateness of the investigation requested with respect to the clinical question and referral
• Possible patient needs and environmental needs
• Factors that may influence the duration and quality of investigations
• The different activation procedures used in paediatric EEG, their indications, contraindications, risks and benefits
• The physiology of hyperventilation
• Grades of photoparoxysmal response
• Safe and correct operation of the equipment to be used, including all peripheral devices
• The importance of confirming the patient’s identity from the referral document and correct entry on the recording system
• The importance of establishing and maintaining effective communication with the patient, including explaining the test in a manner that will ensure cooperation
• The importance of checking there is adequate storage volume for the investigation to be performed
• The effects of sensitivity, display speed, filters, CMRR and sampling rate
• The range of electrodes and transducers used in paediatric EEG recordings
• Factors of key importance to patient history
• Information that should be recorded and the checks for validity
• Effects of medication on the paediatric EEG, including that which may be administered for or during the EEG
• Electrode placement systems used in paediatric EEG
• Potential requirement for modification of the plan

Record a paediatric EEG, to include activation procedures identifying and rectifying the non-pathological features of paediatric EEG recordings

• Local Standard Operating Procedure for paediatric EEG
• The importance of a range of control settings and the importance of reviewing throughout the recording
• The principle and importance of marking electrode sites of placing electrodes and confirming the contact impedances are appropriate to the paediatric patient in clinical context
• Principles of derivation of montages (referential and bipolar) and electrode placement used for paediatric EEG
• The importance of electrode impedance and its effects
• Correct recording parameters
• The importance of patient positioning and compliance
• Requirements and principles of recording paediatric EEG, including identifying and eliminating biological and non-biological artefacts
• The importance of continued information and reassurance for the patient
• The protocol for hyperventilation and its effects on the paediatric EEG, normal and abnormal, and when the procedure should be discontinued
• Intermittent photic stimulation and its effect on the paediatric EEG, normal and abnormal, and when the procedure should be discontinued
• Sleep activation and its importance in the clinical context of the referral question
• Annotation of ongoing recording
• Recognition of and correct response to clinical events

Annotate and interpret a paediatric EEG recording, recognising the normal features (wake and sleep) and abnormalities in paediatric epileptic syndromes and other conditions requiring EEG

• Correct annotation of recordings and other patient documentation and the importance of accuracy, legibility and completeness
• Normal and abnormal features in EEG, awake and asleep
• Maturation of EEG
• Manipulation of data
• Anticonvulsant therapy used in paediatrics
• Identification of the degree of urgency of clinical report
• Hospital and community-based services for patients
• Abnormalities associated with paediatric epileptic syndromes and other conditions requiring EEG, eg anoxic/hypoxic episodes