Implementation of a rapid continuous EEG monitoring program in a community hospital can decrease hospital to hospital...

Electroencephalography (EEG) is an essential tool in the monitoring and management of hospitalized patients with severe encephalopathy, seizure disorders, and post-cardiac arrest encephalopathy. EEG monitoring is often unavailable at all hours in resource- and personnel-limited community hospitals. Transfer to EEG-capable centers has been the typical practice, however this has been increasingly difficult in the post-COVID era and can be associated with increased costs and delayed care.

We performed a retrospective study of the implementation of our Ceribell rapid EEG program from inception in December 2022 to December 2024.

One-hundred eighty nine patients were identified. The overall seizure detection rate was 13.2 % and was highest in patients with clinically suspected seizure (30.8 %). Immediate treatment decisions were made in 41 patients (21.7 %), and this was greatest in post-cardiac arrest patients with abnormal movements (37.5 %). Formal EEG testing was conducted in 83 (43.9 %) patients. Only two patients (1.1 %) had seizures identified on follow-up EEG that were not identified on rapid EEG monitoring. Only two patients (1.1 %) required transfer to a neurointensive care unit for continuous EEG monitoring over the two-year study period.

A rapid EEG program using the Ceribell device can be feasibly implemented to facilitate timely diagnosis of nonconvulsive status epilepticus, and assist in monitoring of post-cardiac arrest and post-seizure patients in an era of increasing staffing and resource limitations.