Intervention Time and Adverse Events in a Canadian Epilepsy Monitoring Unit.
Can J Neurol Sci
; 48(5): 640-647, 2021 09.
Article
em En
| MEDLINE
| ID: mdl-33308345
ABSTRACT
BACKGROUND:
Intervention time (IT) in response to seizures and adverse events (AEs) have emerged as key elements in epilepsy monitoring unit (EMU) management. We performed an audit of our EMU, focusing on IT and AEs.METHODS:
We performed a retrospective study on all clinical seizures of admissions over a 1-year period at our Canadian academic tertiary care center's EMU. This EMU was divided in two subunits a daytime three-bed epilepsy department subunit (EDU) supervised by EEG technicians and a three-bed neurology ward subunit (NWU) equipped with video-EEG where patients were transferred to for nights and weekends, under nursing supervision. Among 124 admissions, 58 were analyzed. A total of 1293 seizures were reviewed to determine intervention occurrence, IT, and AE occurrence. Seizures occurring when the staff was present at bedside at seizure onset were analyzed separately.RESULTS:
Median IT was 21.0 (11.0-40.8) s. The EDU, bilateral tonic-clonic seizures (BTCS), and the presence of a warning signal were associated with increased odds of an intervention taking place. The NWU, BTCS, and seizure rank (seizures were chronologically ordered by the patient for each subunit) were associated with longer ITs. Bedside staff presence rate was higher in the EDU than in the NWU (p < 0.001). AEs occurred in 19% of admissions, with no difference between subunits. AEs were more frequent in BTCS than in other seizure types (p = 0.001).CONCLUSION:
This study suggests that close monitoring by trained staff members dedicated to EMU patients is key to optimize safety. AE rate was high, warranting corrective measures.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Epilepsia
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Can J Neurol Sci
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Canadá