EEG Over The Years

Written by: Elizabeth Huber CLTM, R.EEGT., CNIM, R.EPT., R.PSGT.

I graduated from EEG school in 1989 from a Technical College in the small town of LaCrosse, Wisconsin. I didn’t know it at the time, but it was the best career move I could have made. From there went on to work as an EEG technologist full time and never looked back! I’ve worked in hospitals, the corporate world, and technical colleges through the years. I’ve witnessed a lot of changes in healthcare and EEG over the years, that I thought would be fun to share.

Getting Hired:

Hiring decisions used to be much less structured. There were only in-person interviews, and I was hired on the spot without even a background check. Today, most places require a competency check, background check, and drug test..for good reason!

HIPAA Perspective:

Before HIPAA laws were passed, we sometimes did EEGs on patients that were admitted to the hospital for psychiatric reasons. It was common practice for patients to be transported to the EEG department for testing with the entire patient chart. The chart is a thick 3” or 4” binder full of the entire medical history of the patient being tested. Nothing was off-limits, electronic medical records did not exist back then. Privacy was easily breached for patients. Back then I witnessed medical staff reading psychiatric notes purely out of curiosity of patients that they were not responsible for! I’m so glad that’s over! While I find HIPAA compliance training to be tedious, I can personally attest to the need for it! E

EEG Technology:

As a student and a young EEG technologist back in the late ’80s, we recorded EEGs on analog paper EEG systems.  I could go on and on with stories about how traumatic and/or wonderful those experiences were. The term “paper speed” came from the old analog systems. Here’s an example of what the old analog EEG systems looked like. I worked on Grass, Beckman, and Nihon Kohden 8, 17, and 21 channel systems.  I took my EEG boards (ABRET exams were hands-on where we had to demonstrate that we could do a great EEG hookup and record on the analog machines) on a 17 channel Grass EEG machine. Back then, 20-30 minute routine EEG studies were 10 seconds per page (30mm/sec), and roughly 120 pages per EEG. I encountered my first back strain re-arranging stacks of EEG paper archives. EEG traces were so large that they had to be stored off-site in a warehouse! And yes, the old stories are true…while recording, we knew without looking, when drowsiness, muscle tension, relaxing wakefulness, sleep, interictal discharges, or seizure activity occurred without looking simply by listening to the sounds of the pens! 

Epilepsy Monitoring “LTM”:

My first encounter with LTM was with an old Telefactor telemetry EEG system that saved EEG to a reel-to-reel system, kind of like old movies! Technology evolved from reel-to-reel and audio cassette data storage to VCR tape storage!  That was high-tech then! When we wanted to have EEG tracings to show the reading neurologist for interpretations, we had an elaborate instrumentation setup…

1. Start with the VCR playback, which would output from VCR audio track RCA cable

2. Then into a data decoder, which output that to an analog interface (medusa cable)

3. Which then plugged into the analog EEG headbox

4. Then to the EEG amplifier

5. Then out to a pen writer 

You had to have patience and an attention span long enough to make that work!  We did not have attending staff watching patients 24/7 like today. I always felt as if it would be a lot safer to have 24/7 monitoring. That was prior to seeing published stories of unattended epilepsy monitoring deaths. Today I am happy to see EEG computerized recording on computers with 24/7/365 attended digital recordings! 

Work Environment:

When I was new to EEG, my co-worker that had been around for years, told me that they used to smoke cigarettes in the tech room while recording EEG’s and that had ended not long before then.  We had a neurosurgeon that could smoke in his office despite the indoor smoking ban affecting everyone else. On breaks, we used to take a walk to the birthing center to look at the newborn babies for fun, which is now a security issue. Times have changed for sure. One thing that I suspect hasn’t changed is when telling someone what you do for a living, then that person is still confused and calls you a nurse!