Low Impedance Needles for aEEG in the NICU

Low Impedance Needles for aEEG in the NICU

Low Impedance Needles for aEEG in the NICU: PRO-E5 EEG Electrodes

The Electrode Store's PRO-E5 low impedance needle electrodes are used to monitor brain function in the neonatal intensive care unit (NICU) for a longer period of time and with more convenience/accessibility than traditional EEGs. In traditional EEGs (short 30-60 minute assessments), many high-risk neonates have no seizures, but they may have one or more within 8 to 24 hours. This makes longer-term brain monitoring in newborns very valuable! *Amplitude-Integrated EEG (aEEG) in the Neonatal ICU is becoming more widespread as studies have shown their value.

The PRO-E5 needles have proven to be great for helping detect and monitor neonatal seizures in aEEG, and for monitoring the effects on the brain of different treatments in neonates. They have been on the market for 15+ years, and their quality, safety features, and consistency from one needle to the next is why the devices are popular amongst neonatologists.

When do I use PRO-E5 needle electrodes instead of surface electrodes?

When deciding whether to use low impedance needle electrodes or hydrogel surface electrodes, there are several factors to consider. Generally, needle electrodes are preferred under any of the following conditions:

  1. When the length of monitoring is likely going to exceed a few hours (hydrogels can dry up over time)
  2. When significantly lower impedance is desired (~0-2 kOhms, compared to ~7-17 kOhms in hydrogels)
  3. When time is of the essence (setup time for the low impedance needles is considerably lower than for hydrogels)

Reusable metal surface electrodes present many of the same challenges as hydrogels and have the added risk of cross-contamination and occasional skin irritation.

Other factors to consider:

  1. The neonate's tolerance of handling the skin preparation required by hydrogels (needles require less abrasive skin prep)
  2. Hair, skin condition, and age


The PRO-E5's come in a pack of 4 active needle electrodes (two purple, two black), and are used with a reference hydrogel electrode on the neonate's back or chest. The needles are typically placed in a 3 electrode cross-cerebral configuration (2 needles (P3 and P4), 1 reference) or 5 electrode bilateral configuration (4 needles (C3/P3 and C4/P4), 1 reference) on the neonate, with the reference electrode on the back or chest.


The baby-blue cap ("Protectrode®" cap) is also meant to minimize the risk of accidental needle sticks upon removing the needle from the patient.

- Hold the blue cap and gently pull back on the lead-wire until the needle is fully retracted inside the cap, then discard in the sharps container. 

Protectrode (PRO-E series) Safe Cap Feature

PRO-E5 key takeaways:

• For 1 to 3 channel bedside aEEG monitoring
• Established product with high quality, safety, and consistency (hospitals have been using these needles for 15+ years)
• Compatible with OBM, CFM, and a variety of other EEG / aEEG monitors
• Low impedance (~0-2 kOhms, compared to ~7-17 kOhms in hydrogels)
• Effective for longer duration studies (hospitals may leave them in for a few minutes up to a full day; follow infection control protocol and monitor frequently)
• Minimal risk of needle stick with the Protectrode® baby-blue cap feature (recapping is as simple as pulling the lead-wire back through the baby-blue safety cap)

The Electrode Store is the manufacturer of the PRO-E5 (OBM00046) and is now selling these directly to end users in the USA and distributors outside the US.

Contact us for more information on the low impedance needles for aEEG monitoring.


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