Best Electrode Practices

By Dr. Evan Friedman | April 4, 2022

Myoguide input cable EMG and STIM guidance procedures require a quality hypodermic needle electrode and two surface electrodes.

The needle electrode plugs into Myoguide’s black connector. One surface electrode is connected to the green connector and is for the ground, and the other connects to the red connector and is for the reference.

I heard the mnemonic: “GREE”OUND” for the ground, and RED”FERENCE” for the reference.  I thought that was a great way to keep things straight!

We would like to present the following guidelines to ensure you have the best possible situation for measuring the best EMG signals (and stimulation) from the hypodermic needle electrode, to support your injection guidance procedures. The hallmark we all need to embrace is that we need “Fresh Surface Electrodes!” “Oldies Are Not Goodies”.

Avoid using surface electrodes that have been sitting in an open package laying around without any knowledge of when the package was opened. Surface electrodes will keep for a 2-3 weeks once the foil package has been opened. It’s usually a good idea to place opened packs of surface electrodes in Ziplock bags, once opened.

Please don’t use old electrodes, as they will affect the quality of the EMG signal and the ability to deliver stimulation.

Let’s address the placement of the surface electrodes to help us collect the best possible signals. Some simple pre-planning will gain best results for the entire procedure if one area is being treated. These simple principles will help you create the best opportunities to collect great signals:

  • Clean the electrode sites with alcohol prep swabs.
  • No real need to move the reference and ground electrodes if all the injection sites are close by. Simply select mutually beneficial locations for these electrodes, with respect to the planned injection sites.
  • Most times only the reference electrode needs to be moved if there are bilateral injections.
  • Avoid placing electrodes in areas that will see ultrasound goop! This will avoid short circuits and peeling surface electrodes.

You can visit the Myoguide page for more product details, features, benefits, and specifications if you wish to learn more.

You may purchase your Myoguide EMG/ESTIM BoNT injection guidance system, accessories, and electrodes, directly from the Myoguide Store!  Credit card payments and quotations can be accommodated directly from our website, for your convenience.