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Continuous Video EEG Monitoring

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• Thank you for choosing The University of Kansas Hospital for your epilepsy care.

• The purpose of this video is to orient you to our program and help you know what to expect during your stay.

Welcome

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• The goal of Video EEG monitoring is to determine the type of seizures you are having and to locate where your seizures are coming from in your brain.

• This procedure requires hospital admission so you can be monitored 24 hours a day.

Video EEG Monitoring Overview

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• Video EEG admissions are typically scheduled on a Monday or Tuesday.

• You may check the status of your admission by calling the Admissions Office at 913-588-7193 or 913-588-4588.

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• Your stay will be approximately 3-7 days depending on how frequently you have seizures.

• Your doctor would like to capture at least 2-5 of your typical events.

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• Please bring warm and comfortable clothing to wear, as you may not be able to use blankets during monitoring.

• Shirts must be button-down so they may be changed while your electrodes and telemetry monitor are on.

• You may adjust the thermostat for comfort.

What to Bring

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• You may also want to bring games, movies, books and personal electronics from home to occupy your time.

• Free Wi-Fi access is available to use with your computer or tablet.

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• Your family members are more than welcome to support you during your stay in the hospital, if at all possible.

• They may even be able to help alert us to seizure events.

Family Members

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• Please have clean, washed hair upon arrival without gel, oil, hairspray or grease.

• Remove all extensions, braids, weaves and cornrows, as these will interfere with the electrode application process.

Before You Arrive

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• Please be sure to bring all of your home medications with you. This will ensure the accuracy of your medication record.

• These medications will be secured for safekeeping.

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• On the morning of your admission, we would like for you to arrive no later than 11 a.m.

• Please take your regularly scheduled medications on the morning of your admission.

• While we do everything we can to ensure a bed is ready for you at that time, please know that you may need to wait for a room to become available.

The Morning of Your Admission

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• During your stay, you will be a patient on the 8th floor of the heart center at The University of Kansas Hospital. This is the NEPCU (Neuroscience and ENT Progressive Care Unit).

• This is a 32-bed unit designed to provide a number of services, including stroke care, neurosurgery and epilepsy monitoring.

Neuroscience and ENT Progressive Care

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Your Room

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• During your stay, you will be cared for by physicians, nurses, patient care assistants (PCAs), neuro-diagnostic techs (NDTs) and support staff.

Your Care Team

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• When you arrive in your room, you will be introduced to your primary nurse and patient care associate.

• Your nurse will ask you questions to complete your patient profile.

• IV access and vital signs will be obtained at this time.

Once in Your Room

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• Your nurse will also take this time to orient you to the features of your room.

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• All forms of tobacco are prohibited. This includes cigarettes, e-cigarettes and chewing tobacco.

• We would be more than happy to provide you with a nicotine patch or lozenges.

• If you are ready and willing to quit smoking, please ask your nurse to see a smoking-cessation specialist.

We Are a No-Smoking Campus

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• We want to do everything we can to maintain your privacy and dignity, and we want to do even more to maintain your safety.

Patient Privacy

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• All falls are preventable!

• Falls hurt and cause unnecessary pain and suffering. They could even lead to injury or increase the length of your stay.

Fall Prevention

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• For your safety, staff cannot allow you to perform any task out of bed (or chair) alone that would compromise your safety if a seizure were to occur.

• This includes:– Taking you to the restroom– Staying WITHIN AN ARM’S REACH of you while in

the restroom– And escorting you back to bed

Your Safety

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• Please know that while you are in bed, all 4 side-rails will be raised and padded for your safety.

• This is not intended as a restraint, but rather to prevent falls or injury during a seizure.

Important Information About Your Bed

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• Your physician will ask that you not use any blankets or sheets during your stay, as it is important that physicians be able to see all of your body movements.

• Please dress warmly and adjust the room temperature for your comfort.

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Please do not allow anyone in bed with you – for your safety as

well as theirs.

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• You must stay in your room at all times during your Video EEG stay.

You Must Stay in Your Room

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• To prevent pneumonia, you will be asked to use an incentive spirometer to expand your lungs.

Preventative Care

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• You will be asked to wear leg wraps or sequential compression devices (SCDs) to prevent blood clots.

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• Once your nurse has finished your admission profile, obtained IV access and performed an assessment, electrode application can begin.

Preparing for Monitoring

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Video EEG Application

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Prior to application of electrodes, please take a moment to use the restroom, as it

will be difficult for you to go once application has begun.

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• Initial electrode application will take anywhere from 1-2 hours.

• There will be some light skin scratching of the area where the electrodes are placed.

• You will also notice the smell of glue.

• Glue is necessary for your electrodes to stay in place.

Electrode Application Information

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• The neuro-diagnostic tech will begin by ensuring that your hair is clean and ready.

• The tech will then measure your head.

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• During the measuring process, your tech will mark you with a red wax pencil.

• Your tech will use a Q-tip and gritty paste to remove dead skin cells and oils from your skin. Please note that this process will not break the skin or cause bleeding.

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• As the glue is being applied, you will notice that your head will become cold as the glue is drying.

• You will also notice the room is noisy due to the oxygen setup required to dry the glue.

• You may also notice an odor from the glue. We will do our best to manage the odor by providing a fan.

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• Once you are completely connected to the Video EEG monitor, your nurse or tech will demonstrate the use of the event button and ensure that it functions properly.

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• Your nurse or tech will also instruct you to do your best not to obstruct the view of the camera(s).

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Please do not touch any of the monitoring equipment.

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For your privacy, the bathroom does not have video capability.

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• The goal of Video EEG monitoring is that we are able to observe, record and classify your seizure events.

During a Seizure

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• When you are thought to be experiencing a seizure, staff on the floor will be notified by either:

– Your loved one or staff pressing the event button

OR– An overhead page from the

monitor tech in the EMU

Sounding the Alarm

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• At the time an event button is pressed, your nurse and PCA will enter the room.

• Your nurse will monitor your positioning and vital signs to ensure your safety.

• Your nurse or tech may also press the event button again to ensure the recording is marked properly.

Event Button

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• Once your nurse has determined that you are safe, your nurse will begin an assessment.

• To do this, your nurse will ask you to remember two words.

• Your nurse will also ask you to follow a series of simple commands.

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• As your event continues, your nurse will continue to ask you to repeat the words you were asked to remember.

• You will also be asked questions to determine your level of consciousness.

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Your nurse will stay with you until you have returned to baseline.

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During an event, your loved one should remember to:

1. Remain calm.

2. Note the time your event began and any warning you may have experienced (if applicable).

3. Stay clear of the camera.

Patient Support Provider’s Responsibilities

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• We encourage you and your loved one to say out loud – to the camera – the symptoms you are experiencing before, during and after an event.

• This can better help us classify your events.

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Your physician will want to see 2-5 of your typical events.

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• Once your physician has seen enough seizures to classify your events, you are ready to be disconnected from the Video EEG monitor.

Disconnection and Discharge

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• Electrode removal will be much faster than application.

• But this process requires the use of acetone, which has an odor.

• We are happy to provide a fan to aid in air circulation and increase your comfort.

Electrode Removal

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• You may experience itching, abrasions and hair loss where the electrodes were placed on your head.

• It may also take several washings to remove all of the “glue.”

• 100% real mayonnaise may also help with glue removal.

After Removal Information

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• Your nurse will provide you with individualized discharge instructions.

• As you have been admitted with a seizure condition, it is imperative that you observe seizure precautions:

Do not drive, operate machinery, climb ladders, work at heights, cook using a stove, swim or bathe in a tub alone.

Returning Home

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• Your nurse will review your specific medications with you and alert you to any changes in your medication regimen.

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• Please be sure to have arranged transportation home prior to your Video EEG admission.

• Also be sure to take all of your belongings home with you. We do not want you to lose anything.

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• Please take this time to ask your nurse or physician any questions you may have about this presentation or about the Video EEG monitoring process.

Questions

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• Thank you for viewing this presentation.

• We wish you the best of luck in managing your condition and are grateful you have entrusted The University of Kansas Hospital with your care.

Thank you

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Continuous Video EEG Monitoring