Skin safety is a hot-button issue for neurodiagnostic technologists, because EEG placement requires skin abrasion. Even this small amount of disruption to the skin’s protective barrier can increase infection risk.

And November, which is American Diabetes Month, is a great time to learn the special measures you need to take to protect diabetic patients who are more prone to skin infection.

Diabetes impairs blood flow and sensation in the skin, decreasing pain response. That means once a wound forms, it can remain open for long periods, increasing infection risk.

Approximately 34 million people in the U.S. have diabetes and another 88 million adults have been diagnosed as prediabetic.

The Standards and Practices Committee of ASET-The Neurodiagnostic Society recently created a Skin Safety Task Force  to address the increased infection risk for diabetics. Resources provided by the task force include:

These resources encourage skin safety policies that include detailed protocols for skin inspection, tracking, and reporting. The Task Force resources also emphasize the importance of preventing pressure ulcers. Pressure ulcers develop underneath electrodes, especially during long-term monitoring.

According to a 2019 study, inflammation underneath electrodes was more likely to occur in older patients, as well as those with fine hair and dry skin, another common feature in patients with diabetes. Pressure ulcers are also more likely to occur in patients with limited mobility, such as patients in the ICU.

To prevent ulcers, the Skin Safety Task Force recommends “a cushion placed under the head/neck to relieve the pressure of the electrodes. Silicone/gel packs are helpful in relieving pressure.” They also recommend rolled gauze for holding electrodes in place without excessive pressure.