Impact of the COVID-19 Pandemic on Continuous EEG Utilization

Abstract

The coronavirus disease 2019 (COVID-19) has significantly impacted healthcare delivery and utilization. The aim of this article was to assess the impact of the COVID-19 pandemic on in-hospital continuous electroencephalography (cEEG) utilization and identify areas for process improvement.Methods: A 38-question web-based survey was distributed to site principal investigators of the Critical Care EEG Monitoring Research Consortium, and institutional contacts for the Neurodiagnostic Credentialing and Accreditation Board. The survey addressed the following aspects of cEEG utilization: (1) general center characteristics, (2) cEEG utilization and review, (3) staffing and workflow, and (4) health impact on EEG technologists. Results:The survey was open from June 12, 2020 to June 30, 2020 and distributed to 174 centers with 79 responses (45.4%). Forty centers were located in COVID-19 hotspots. Fifty-seven centers (72.1%) reported cEEG volume reduction. Centers in the Northeast were most likely to report cEEG volume reduction (odds ratio [OR] 7. 19 [1.53-33.83]; P ¼ 0.012). Additionally, centers reporting decrease in outside hospital transfers reported cEEG volume reduction; ; P # 0.0001. Twenty-six centers (32.91%) reported reduction in EEG technologist coverage. Eighteen centers had personal protective equipment shortages for EEG technologists. Technologists at these centers were more likely to quarantine for suspected or confirmed ]; P ¼ 0.058.Conclusions: There has been a widespread reduction in cEEG volume during the pandemic. Given the anticipated duration of the pandemic and the importance of cEEG in managing hospitalized patients, methods to optimize use need to be prioritized to provide optimal care. Because the survey provides a cross-sectional assessment, follow-up studies can determine the long-term impact of the pandemic on cEEG utilization.

Intermittent Frontal Rhythmic Discharges as an Electroencephalogram Biomarker of Acute SARS-CoV-2 Infection-Associated Encephalopathy in Children

“…Limitations and disruption of EEG resources availability to COVID-19 patients with neurological or critical symptoms have been noted across different health systems [29,30]. Unfortunately, and following a long history of disparity and inequality, children's access to EEG services has been more preferentially jeopardized [31].…”

EEG as an indispensable tool during and after the COVID-19 pandemic: A review of tribulations and successes

“…Governmental and institutional regulations led to the diversion of clinical resources to support COVID-19 initiatives. There was also a reluctance to perform EEGs and transfer patients between hospitals to avoid contracting and spreading COVID-19 to EEG staff (6,20). The reduced inter-hospital transfers impacted the use of EEG.…”

“…The reduced inter-hospital transfers impacted the use of EEG. Many facilities often refer patients to larger centers for inpatient EEG and continuous EEG (cEEG) monitoring that are unavailable at their institution (6). Further, expert recommendations specifically addressed the need to avoid urgent evaluations for non-urgent testing, which included diagnostic EEG (21).…”

“…The dearth of well-trained EEG technologists was apparent during the pandemic, with the subsequent reduction in staffing of clinical EEG services to support the response to the COVID-19 pandemic (6,20,33). Prior studies before the pandemic noted a demand for nearly 40,000 jobs for neurodiagnostic technicians in the future and a lack of sufficient training programs to meet this need (34), and the pandemic exacerbated this problem.…”

Elective inpatient video‐EEG monitoring during the COVID‐19 pandemic

“…Protocols for chronic care such as peritoneal dialysis were modified to provide safety measures to allow for continued provision of essential care with less risk to patients and staff [4]. The utilization of continuous EEG in the critical care setting decreased at most centers in the United States [5]. In Europe, inpatient scalp video-EEG stopped at most adult centers and utilization decreased at most pediatric centers [6,7].…”