Abstracts

Rationale: As the field of continuous EEG (cEEG) monitoring in the critical care setting expands, the need to quantify, categorize, and study the data gathered also expands. In 2012, the ACNS published critical care EEG terminology in an effort to improve clinical research and management of patients requiring cEEG monitoring. With the shift in terminology, there is potential for reduced familiarity amongst providers, and possible effects on clinical correlation and decision making of primary teams. We sought to understand the familiarity of providers in our Neurocritical care (NCC) program with this terminology two years after implementation at our institution. Methods: We administered a 21 question web-based survey to NCC fellows, advanced practice providers (APPs), and attendings, who staff a 22 bed Neurocritical care unit. Questions assessed basic EEG knowledge, understanding of ACNS terminology, and clinical EEG application. Results: There were 5 attending physicians, 4 NCC fellows, and 13 APPs. Attending physicians and APPs had a median of 4 (range: 3, 13) and 2 years (range: 0.25, 15) experience since most recent post graduate training, respectively. All data is reported for APPs and physicians respectively as percentage correct. Basic knowledge of EEG frequencies and reactivity 15.4% and 77.8%; 7.7% and 55.6% respectively; ACNS electrographic seizure definition 84.6% and 88.9%. Main terms: generalized 38.5% and 66.7%; lateralized 7.7% and 44.4%; bilateral independent 61.5% and 77.8%; multifocal 23.1% and 66.7%. Modifiers: +F 46.2% and 88.9%; +R 76.9% and 100%; +S 53.9% and 100%. Attenuation/suppression descriptors: continuous 53.9% and 66.7%; near continuous 15.4% and 77.8%; discontinuous 15.4% and 77.8%; burst suppression 30.8% and 55.6%; suppression 23.1% and 55.6%. Prevalence descriptors: continuous 53.8 and 100%; abundant 53.8% and 88.9%; frequent/occasional/rare 61.5% and 88.9%. Duration descriptors: very long/long/intermediate 76.9% and 100%; brief/very brief 69.2% and 88.9%. The highest rated component of the cEEG report that influenced patient management was "conversation with epilepsy fellow/attending," selected by 92.3% of APPs and 100% of physicians. Conclusions: The responses from this survey demonstrate a wide spectrum of familiarity and knowledge in understanding the terminology developed by the ACNS. These findings highlight the importance of communication between NCC providers and epileptologists, as well as areas of potential education for providers of all training levels. Funding: None