Which recommendation can minimize stimulus artifact while recording the BAER in the operating room?

Using alternating clicks is recommended to minimize stimulus artifact while recording Brainstem Auditory Evoked Responses (BAER) in the operating room. The rationale behind this is that alternating clicks can help in achieving a more balanced and symmetrical stimulation of the auditory pathways. This balance tends to reduce the likelihood of stimulus-related artifacts, which can interfere with the reliable interpretation of the auditory evoked potentials.

Stimulus artifacts occur as a result of the electrical activity generated in response to auditory stimuli, which can obscure the actual evoked potentials being measured. By employing alternating clicks, the two auditory stimuli (the positive and negative phases of the click) help to cancel out some common mode interference and improve the signal-to-noise ratio, thus enhancing the clarity of the recorded response.

Other options may provide benefits under certain circumstances, but they do not specifically address the phenomenon of stimulus artifact as effectively. For instance, using larger headphones could improve sound delivery and subject comfort, but it does not inherently minimize the stimulus artifact. Similarly, using rarefaction clicks focuses on a specific type of stimulus but may not address artifacts directly in the same manner as alternating clicks. Decreasing the impedance of stimulating electrodes is important for ensuring good signal quality, but it does not directly minimize the stimulus artifact resulting