CLA PreScan Checklist Implementation
PreScan Checklist Implementation
Probably the most troublesome aspect of using surface EMG, and the thing that produces the greatest doubt and lack of certainty, is when the scans don't look like you would expect them to look. And probably the most common reasons for that is overlooking things the patient may be doing that compromises the integrity of your scans.
The PreScan Checklist was specifically developed for CLA doctors who want to avoid unexplainable scans and begin their nervous- system-focused patient education while the patient is still in the reception room completing their admitting paperwork.
Add this simple checklist to your admitting paperwork package to help obtain the best baseline scan possible by identifying recent patient behaviors that could compromise the accuracy of your scan, or, determine if the scan should be postponed to a subsequent visit. Bringing more rigor to this will help you reach better clinical decisions and make comparisons with subsequent scans more meaningful for you—and the patient.
Implementing the PreScan Checklist also serves as a "heads up" to patients that medications, alcohol, caffeine and other factors can adversely affect their nervous systems. Optimally, each patient should be warned when establishing their initial appointment, that they should try to avoid these items (or at least, delay taking any prescription medications) until after their scan.
But remember, you cannot overrule the recommendations of their medical doctor simply for the sake of getting a clean scan! And it's imperative that you communicate to your entire office team the serious legal implications of offering any advice concerning the patient's prescription drug use. You're merely uncovering this information so you can make the decision to scan, or to postpone the scan.
We've included language at the top of the form to explain why you're asking your new patient these simple, yes-or-no questions. It reads:
"Your nervous system controls and regulates every cell of your body. We use an instrument that reveals how well your nervous system is working. Please let us know if we should be mindful of the following:
Then there's a series of nine questions.
When you review the Checklist and find a "Yes" response, you'll want to dig a little deeper. Then, you'll have a decision to make: to scan or not to scan?
Realize, that if the patient has checked "Yes" to any of the answers—and you proceed with the scan, the results may be unpredictable.
Here's an example of how to weigh these factors.
Let's say they reveal that they're coffee drinkers and they regularly consume say, two cups of coffee by the time of the day their scan is scheduled, and on the day of their scan they have had their usual amount. This then is "normal" as far as their regular routine (even though it may not be a healthy one) and it would make sense to proceed with the scan.
Or, consider the reverse. If they regularly drink two cups of coffee, and in preparation for your scan have not had their usual amount, their nervous system is likely to be in an abnormal state. Use your best judgment and keep this factor in mind when you see the scan.
Medications, especially anti-histamines, can have a profound effect on their scan—sometimes for hours afterwards. If the patient is taking these or some other drugs, and scheduling their scan earlier in the day before taking their medications isn't practical, make a note in the patient's records. Later, if possible, on subsequent rescans you'll want to replicate the same chemical environment, time of day, etc. so you'll be comparing apples to apples.
And one more thing about drugs. These days many people take such a cavalier approach to over-the-counter-medications that they don't think popping a few pain relievers earlier in the day is even significant enough to mention! Be sure to ask if you suspect this might be the case.
Now, if the patient has checked one or more "Yes" answers, the most rigorous approach is to postpone their scan. Explain that the listed items are stressors to the nervous system and that they can distort the results. Or, you can still conduct the scan, but just be sure to consider these issues if you see unusual scan results.
Like fasting before a blood test, most people have become accustomed to making preparations prior to seeing the doctor. In fact, for many, having to wait until their next visit to be scanned is likely to elevate the perceived value and importance of the scan. Naturally, if you adjust them before conducting the first scan, this too can distort your baseline and make future scan comparisons less meaningful.
And naturally, if the person has a sunburned neck you'll want to wait several days before doing the scan.
The PreScan Checklist is easy to use and helpful, not only to avoid unexplainable scans, but as a springboard to begin your patient education protocol about the supremacy of the nervous system.