Integrating Neuromonitoring in Pediatric Emergency Medicine: Exploring Two Options for Point-of-Care Electroencephalogram (pocEEG) via Patient Monitors—A Technical Note

Abstract

Central nervous system (CNS) disorders are among the most frequent presentations in critically ill children. Status epilepticus (SE) is a frequent scenario in the resuscitation bay. In patients with altered mental status, non-convulsive SE (NCSE) is often underrecognized and critically impacts the neurological outcome and duration of hospitalization. An electroencephalogram (EEG) is required to diagnose NCSE. However, standard EEG recordings are time- and staff-intensive, and their availability is limited, especially outside regular working hours. We aimed to improve patient care by developing a simplified EEG recording method, using a reduced lead montage (point-of-care EEG—pocEEG), that is suitable for use in pediatric emergency departments. The objective was to devise a cost-effective unit with low space requirements that fitted the existing technical infrastructure. We present two technical options for clinical pocEEG acquisition using patient monitors (GE Carescape, Philips IntelliVue) that enable data collection for educational and research purposes. A simplified, rapid response EEG like the pocEEG enables neuromonitoring of patients with CNS disorders in pediatric emergency settings, facilitating timely diagnosis and treatment initiation when standard EEG is not readily available.

Paediatric Neurology: Current Trends, Rehabilitation, and Future Challenges

“…However, standard EEG recordings are time-and staff-consuming, and their accessibility is restricted, especially outside regular working hours. In their technical note, Simma et al [3] reported on the application of a simplified EEG recording technique, using a reduced lead montage (point-of-care EEG-pocEEG), for identifying NCSE and managing its treatment. This new instrument allows neuromonitoring of paediatric patients with neurological conditions, simplifying opportune diagnosis and treatments when a standard EEG is not readily accessible.…”