Article by: Alan Ettinger, MD FAES, Medical Director, Safe Passage EEG Services Nationally-known neurologist, medical author and clinical researcher
According to the American Society of Electrodiagnostic Technologists (ASET), there is a “nation-wide shortage of qualified, highly skilled, neurodiagnostic technologists” who can perform a study of brain function known as the electroencephalogram (EEG).
Routine EEG: A Brief Snapshot
In the hospital setting, the EEG is crucial for aiding in the diagnosis of diverse conditions that involve the brain. Some medical centers are equipped to provide the routine EEG during regular weekday hours. The routine EEG is a 20-30 minute test of brainwave function, which screens for markers for risk of seizures, as well as demonstrates evidence of brain dysfunction that may occur with dementia or depressed consciousness. While the routine EEG can be invaluable as a screening tool for brain disorders, it is a relatively brief snapshot of brainwave activity. Given its brevity, it is unlikely to capture clinical episodes such as seizures. The routine EEG may also fail to display epilepsy waves that occur infrequently and does not permit study of abnormalities of deep sleep. Many hospitals, even major academic medical centers, struggle to provide routine EEGs after hours and during the weekend.
Continuous EEG (cEEG) Becoming Standard of Care
Further complicating this need, are frequently encountered situations in which actual clinical episodes need to be captured for analysis. This is accomplished by continuing the EEG beyond 30 minutes, sometimes for hours or days. Continuous EEG (cEEG) is sometimes accompanied by a video recording so that both behavioral and EEG data can be assessed. This is particularly invaluable in the diagnosis and management of subclinical, subtle or documented persistent seizures (status epilepticus). It is also critical in assessing prognosis after cardiac arrest and in identifying inadequate blood vessel blood flow (ischemia and vasospasm).
An estimated 20% of comatose patients have intermittent or continuous seizures as the cause for altered consciousness. Even more subtle examples of depressed consciousness among hospitalized patients are often due to a non-shaking form of continuous seizures (non-convulsive status epilepticus). Alternatively, many disorders may be erroneously treated with antiepileptic therapies but turn out to be nonepileptic conditions (e.g. sleep disorders, movement disorders, behavioral changes, psychogenic events, syncope). Continuous EEG (cEEG) is rapidly becoming the standard of care for detecting and managing occult or obvious seizures or for detecting and managing status epilepticus. Rapid application of the EEG in suspected status epilepticus is essential since a delay results in a much lower chance of aborting seizures and dramatically elevated morbidity and mortality.
How Hospitals Can Benefit From Providing a Complete Range Of EEG Services
Providing prompt EEG testing reduces morbidity and mortality, attracts new patients to the medical center, reduces the need to transfer patients to alternative facilities and mitigates medical centers’ liability. Seizure mismanagement is one of the most common issues in neurology-related litigation, and failure to readily detect and treat seizures has been the subject of lawsuits. The implementation of a comprehensive EEG program with routine and continuous EEG reduces these risks.
SafePassage EEG Services can Provide a Turnkey Solution
Given the EEG technologist shortage, how can hospitals meet the needs of their patients? Safe Passage EEG Services can help. Our team of experts, partner with hospitals and neurology practices to provide turnkey solutions that enable comprehensive EEG programs. Including, but not limited to staffing, education and training, and extended monitoring services, we provide broad assistance to enhance clinical neurophysiology services.
Led by an outstanding nationally-known leadership team, Safe Passage EEG Services can help you meet these challenges. If we can be of any assistance to you, please contact our Scheduling Hotline 24/7/365 for emergent cases and confirmations: 855-WE-DO-EEG (855-933-6334)
To learn more about SafePassage, visit NuVasive Clinical Services here.