Improving STAT EEG Coverage by Integrating POC EEG into the Neurodiagnostic Program
Abstract number :
2.027
Submission category :
3. Neurophysiology / 3C. Other Clinical EEG
Year :
2023
Submission ID :
666
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Veeresh Kumar N. Shivamurthy, MD – Saint Francis Hospital and Medical Center, Trinity Health Of New England, CT
Ashwaan Uddin, MD – Swedish Medical Center; Damian Moskal, MD – Trinity Health Of New England
Rationale: As seizure-related ED visits grow along with high rates of seizures in critically ill ICU patients, 24/7 EEG is in high demand. A shortage of trained EEG techs and the high cost of EEG has limited the hours of coverage for this vital diagnostic tool. Our Level 1 Trauma Center evaluated a Point of Care EEG system (POC EEG) (Ceribell) with automated bedside seizure detection to address these challenges
Methods: We retrospectively reviewed all EEGs during a six month period across three consecutive years, 2020 through 2022. The first year used only conventional EEG without POC EEG. All studies were categorized as inpatient conventional EEG, POC EEG, EMU or outpatient. The inpatient EEGs were labeled STAT vs non-STAT
Results: In year one, STAT EEG accounted for 16% of all inpatient EEGs. In year two and three, it accounted for 34% and 37% of all EEGs. POC EEG accounted for 52% of all STAT EEGs in year two and 88% in year three. The subset of STAT EEGs occurring after-hours accounted for 3% in year one, then 17% and 25% in years two and three. POC EEG accounted for 69% and 97% of afterhours STAT EEGs in years two and three respectively. Outpatient EEG volume grew four-fold from year one to two. In year three, an EMU was added. Outpatient + EMU volume in year three was consistent with the prior year outpatient, at +6% growth. EEG tech staff shifted from inpatient to focus on outpatient care. In year two, one EEG tech was hired as POC EEG was expanded to 24x7 coverage. In year three, two EEG techs and an Epileptologist were hired. These additions were not correlated with an overall increase in inpatient EEG volume
Conclusions: Access to POC EEG allowed for increased STAT and after-hours EEG for acute care patients. It also allowed conventional EEG resources to manage existing epilepsy patients in the EMU and outpatient settings. We identified more patients in need of continued EEG monitoring across inpatient, outpatient, and EMU, leading to department expansion
Funding: Research funding was provided but did not influence the outcomes.
Neurophysiology