Abstracts

Rationale: The epilepsy monitoring unit (EMU) evaluation is a necessary tool in the evaluation of patients with epilepsy or suspected epilepsy. However, the act of provoking and capturing seizures poses risk to the patient, most notably due to falls, injuries and potentially cardiopulmonary complications. Given these inherent risks, miscommunication and incomplete training about the importance of when and why certain measures are taken can cause critical gaps in care for patients in an especially vulnerable state. Identifying and addressing these gaps in care is a critical element in proper EMU care. Our initial goal is to understand baseline practice of safety and testing assessments in the EMU using a scoring checklist followed by implementation of a novel simulation-based training for all EMU staff and reassessment of EMU practice.

Methods: EEG and Video review of consecutive patients admitted to Baylor St. Lukes EMU from July to September 2020. Included patients include all patients with epileptic seizures. A total of 15 patients with 69 epileptic seizures were included in the analysis. Authors JG and JC reviewed all cases using a developed checklist that was designed to assess performance of recommended safety and testing practices. Compiled data included EEG and clinical seizure onset and offset as well as first response by staff.

In a second step, a simulation training program was developed using a high-fidelity manikin beginning with a patient pushing the button for a habitual aura, progressing to a dyscognitive seizure that evolves to bilateral tonic-clonic activity.

Reassessment of EMU safety and testing practices will be performed after all staff have completed the simulation training program.

Results: Initial EMU case review over a three month period included 69 epileptic seizures occurring in 15 patients. Average response time after EEG onset was 46.2 seconds and 27.7 seconds after clinical onset. Staff are currently undergoing stimulation training and formal comparisons of pre and post intervention will occur after completion of the training.

Conclusions: Safety and testing training for all staff in the EMU is of paramount importance in the optimal evaluation of patients. Use of simulation based training can be an effective strategy to ensure standard of care is met across all staff.

Funding: Please list any funding that was received in support of this abstract.: None.