Abstracts

Rationale: Delays inidentification and treatment of non-convulsive status epilepticus (NCSE) may result in increased morbidity and mortality. An emergency electroencephalogram (EEG) is often difficult to obtain due to lack of EEG technologists and readily available electroencephalographers for immediate interpretation. The conventional method of EEG lead application is time consuming and can only be performed by specially-trained personnel. The StatNet electrode set is a system that could be applied by non-EEG personnel after minimal training. We have previously shown that EEGs recorded using the StatNets are comparable to conventional recordings. This study is designed to assess 1. The feasibility of using StatNet electrodes for stat EEGs in the ED, 2. Compare the time delay to EEG acquisition and interpretation between the StatNet and conventional EEG group, 3. Evaluate the impact on flow of patient care in the ED. Methods: Our hypothesis is that using StatNet electrodes will decrease the delay to EEG interpretation and facilitate patient care in the ED. For urgent EEG requests from the ED, minimally trained ED staff applied StatNet electrodes to record EEGs. We compared the following parameters between patients receiving StatNet EEGs with those receiving conventional EEGs in the historical control group: 1. Time from EEG request to start of EEG acquisition, 2. Time from EEG start to time of communication of results to ED staff, and 3. Time from EEG start to time of ED disposition. The nonparametric Mann-Whitney two sample T-test was used for comparisons, and results are expressed in mean minutes +/- standard error of the mean. Results: The delay from the time of EEG requisition to the start of EEG acquisition in the StatNet group was significantly shorter at 72.6+/-9.3 (N=25) than the historical control group which was 164.6+/-32 (N=23), P = 0.02 (Figure 1A). The time delay from EEG acquisition to communication of results to ordering physicians was also significantly shorter in the StatNet group, 54.6 +/-3.6 (N=25) compared to historical controls, 158+/-47.5 (N=25), P = 0.008 (Figure 1B). Finally, the time from EEG start to ED disposition was significantly shorter in the StatNet group, 205.5+/-21.2 (N =23) versus historical controls 374+/-7.2 (N=25), P = 0.0005 (Figure 1C). Conclusions: This study demonstrates feasibility of using the StatNet electrodes for emergency EEGs by non-EEG trained personnel. The StatNet EEGs were associated with significantly shorter delays in obtaining the study and communication of results to the responsible physician. It also facilitated patient management by reducing the time spent in the ED, reflecting timely treatment or transfer to the relevant services for further treatment. Thus, it is a desirable method to obtain urgent EEGs to facilitate rapid diagnosis of NCSE. Furthermore, it has the potential for widespread use and may improve the care of patients in the ED, by reducing time spent in the ED while reducing health care costs.