Rationale:
We aim to determine whether point-of-care electroencephalography (POC-EEG) monitoring using the Ceribell device can reduce time from hospital arrival to EEG and successful treatment of seizure activity when compared to conventional 10-20 EEG. Ceribell is a point-of-care electroencephalography (POC-EEG) device that includes machine-learning algorithms to detect status epilepticus without the requirement of a trained technologist. We compared time to monitoring and outcomes with POC-EEG against conventional EEG.
Methods:
A process improvement paradigm was implemented in which POC-EEG was used for suspected seizure activity when 10-20 EEG monitoring was not immediately available (off-hours 6pm-8am, June 2021 to June 2022). Data regarding diagnostic testing and seizure treatment were compared to patients monitored in the preceding period using the conventional paradigm (Mar 2020 to May 2021).
Results:
Of the 142 patients with suspected seizure activity for whom an EEG was requested during off-hours, 85 (60%) were monitored using POC-EEG. Compared to those monitored using a conventional 10-20 system, those monitored with POC-EEG had no significant clinical differences between groups (i.e., age, race, ethnicity, history of seizure, indication for EEG). Among patients monitored within 24h of hospital arrival for presumed seizure (n=97), POC-EEG was associated with shorter time to monitoring (median 225min [IQR 76-422] vs. 567min [IQR 290-914], p< 0.001). Only eight monitored patients experienced electrographic seizures (n=3 for POC-EEG), precluding comparisons in time to seizure detection, treatment, or cessation. In 72% of patients monitored, POC-EEG was thought to have expedited diagnostic testing or treatment.