Introduce yourself and explain that you are treating his/her patient for dysphagia and would like to use NMES
Explain placement in submental region and frequency of 50 Hz and a phase duration of 130 uSec to 400 uSec
Indicate that you plan to set up appointment with pacemaker rep for interrogation to check interference
If physician indicates that this is unnecessary, ask for documentation, such as script that indicates “Ok to proceed with NMES
2. Contact Pacemaker Company
Call number on back of patient’s pacemaker card
Request interrogation and interference testing
Give requested information, such as reason, location, etc.
3. Discussion with Pacemaker Rep
Explain that you want to use NMES with the patient
Indicate that you have spoken with cardiologist
Schedule time with rep to allow both of you to be present with the patient
Interrogation and test for interference is a free service
4. Appointment
Rep will set the patient up and interrogate the pacemaker
Place the electrodes and be ready to go
The rep will place a magnet over the pacer to prevent a shock from occurring, but still allows it to function
Explain to the patient that you need to increase as high as you can to ensure there will not be a problem during later treatments
Set the device with standard parameters indicated for treating that particular patient
Turn on and progress mA to max; the rep will have a digital display to tell if there is interference; if so discontinue and do not proceed with use; if not, you can proceed with use in treatment
5. Documentation
Ask rep for a printout of the graph
Sign it, along with signature from the rep
Write the date and the parameters used and document in the chart as well
Example: “Guidant rep Mary Smith provided pacemaker interrogation and interference testing for NMES in
the submental region for potential treatment of dysphagia. Equipment tested at frequency of 50 Hz, phase duration of 180 uSec, placement in submental region. No interference noted.”