Why Single-Use Electrodes Are Being Singled Out as EEG Labs Begin to Open

Single-use EEG cup electrodes got another boost recently when they were discussed by industry leaders at a town hall held by ASET-The neurodiagnostic Society.

ASET convened the meeting to address issues surrounding the resumption of neurodiagnostic services amid a pandemic. Their panel of experts included EEG technologists in leadership positions at medical centers across the country. “We use disposables for everything,” was a phrase used more than once when panelists were asked which EEG electrodes they are using now that labs are reopening.

“I personally think we should all be using disposables,” said panelist Cheryl Plummer, manager of the Epilepsy Monitoring Unit at Presbyterian Hospital in Pittsburgh, Pennsylvania. “But I know that might not be possible everywhere.”

We recently wrote about how the COVID-19 pandemic has led to a surge in the use of single-use electrodes over reusables. The impetus for the increase largely comes down to infection control, but as the townhall panelists explain, it’s not the only reason.

The issue most labs have with using single-use EEG cup electrodes is cost. Though reusables are more expensive per unit, labs need to buy fewer sets. This makes them arguably cheaper than the single-use electrodes, which have to be purchased more often. However, some research suggests this is not the case, especially when considering the costs surrounding reusables. These include things like the man-hours needed to clean electrodes and the potential cost of hospital-acquired infections.

“I think it is kind of a wash,” said Plummer in response to a listener’s question about this cost differential.

Another panelist, Donald “Trei” King III, Director of Neurophysiology at Children’s of Alabama, agreed – the benefits outweighed the negatives, he said. Cost was a consideration but there was another benefit.

“At our facility it was just a whole lot easier for us to go completely disposable, especially with all the Joint Commission questions that come up with your processes,” King added. “It can become a nightmare.”

For our post on ASET’s updated infection-control guidelines, author Anna Bonner also talked about the Joint Commission’s increased attention on cleaning procedures.

Beyond these considerations, labs might want to consider switching to single-use electrodes for another reason: time savings. In their paper on performing EEGs on COVID-19 patients, Haines et. al recommend single-use electrodes in reducing the amount of time techs need to handle the electrodes and risk exposure to the virus.

Susan Agostini, manager of the Clinical Neurophysiology Practice Lab at the Mayo Clinic Phoenix/Scottsdale in Arizona, said her techs have seen similar time savings. The reason? Every patient gets a brand-new shiny set of never-been-used single-use electrodes for each procedure and the signal is great.

“In our facility, we went through that transition from reusable leads to disposable. The biggest highlight of the change has been the satisfaction of the techs,” Agostini added. “They were completely amazed with the quality of the EEG, the amount of times they don’t have to come back and reapply things and change electrodes, and the time it takes them to perform an EEG or a continuous EEG has decreased tremendously.”

For those techs who believe they should be using single-use electrodes but are having difficulty convincing administrators, Mary Betinis, director at UCSF Health, Epilepsy and Neurodiagnostic Services, suggests working in tandem with your hospital’s infection control/ risk assessment team. They can help you weigh the costs and argue your case to administration.

“I think the organization would definitely support you in being proactive to mitigate risks.”

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