ICU cEEG Monitoring and Indications
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Questions and Answers

What is the minimum voltage required to define an electrographic seizure?

  • 1 µV
  • 5 µV
  • 10 µV
  • 2 µV (correct)

    • What is the term used to describe the evolution in frequency, voltage, morphology, or location of an electrographic seizure?

  • Abnormal pattern
  • Evolving pattern (correct)
  • Repetitive pattern
  • Rhythmic pattern

    • Which of the following is NOT a type of QEEG trend?

  • Seizure detection
  • Rhythmicity spectrogram
  • Heart rate variability (correct)
  • Density spectral array (DSA)

    • What is the purpose of EEG testing in the ICU?

    <p>To determine whether a patient is suffering from seizures and whether they are focal or generalized</p> Signup and view all the answers

    What is the term used to quantify seizure burden for clinical purposes?

    <p>All of the above</p> Signup and view all the answers

    What is the term used to describe the variability of background alpha activity in a QEEG trend?

    <p>Relative alpha variability (RAV)</p> Signup and view all the answers

    What is the primary indication for CEEG monitoring?

    <p>Seizures, NCS, and NCSE</p> Signup and view all the answers

    What is the duration of an electrographic seizure?

    <p>At least 10 seconds</p> Signup and view all the answers

    What is the significance of QEEG trend changes during vasospasm in patients following SAH?

    <p>They have a direct influence on improving patient outcome by recognizing the changes and notifying the interpreting physician</p> Signup and view all the answers

    What is the usual pattern associated with impaired cerebral function?

    <p>Slowing of the EEG background activity</p> Signup and view all the answers

    What type of damage produces continuous focal slowing seen maximally over the damaged area?

    <p>Structural damage</p> Signup and view all the answers

    What is a favorable prognostic feature in EEG?

    <p>Background continuity</p> Signup and view all the answers

    What is the purpose of EEG in predicting outcome in neurologic conditions?

    <p>To determine the nature of encephalopathy or coma</p> Signup and view all the answers

    What is a clinical population in which EEG may aid in prognosis?

    <p>All of the above</p> Signup and view all the answers

    What is the significance of EEG parameters in predicting outcome?

    <p>They have a high false-positive rate</p> Signup and view all the answers

    What is the purpose of prolonged monitoring in EEG?

    <p>To determine whether prolonged monitoring is superior to briefer EEG recordings</p> Signup and view all the answers

    What is the recommended sensitivity setting for at least 30 minutes of the recording?

    <p>2 µV/mm</p> Signup and view all the answers

    What is the primary consideration when selecting an electrode application method for a patient in the ICU?

    <p>The patient's clinical situation</p> Signup and view all the answers

    What is the primary focus of neurologic critical care?

    <p>Recognition and treatment of secondary insults</p> Signup and view all the answers

    What type of electrodes are typically used for cEEG monitoring in the ICU?

    <p>Gold disk cup electrodes</p> Signup and view all the answers

    What is the primary benefit of continuous EEG monitoring in the ICU?

    <p>Identification of seizures and vasospasm following SAH</p> Signup and view all the answers

    What is the primary goal of EEG intraoperative monitoring and ICU monitoring?

    <p>To intervene in time to avoid neurologic deficits</p> Signup and view all the answers

    What is a common source of artifacts in ICU cEEG monitoring?

    <p>Equipment and patient care maneuvers</p> Signup and view all the answers

    What is the recommended minimum distance between electrode montages?

    <p>10 cm</p> Signup and view all the answers

    What is the consequence of nonconvulsive seizures and nonconvulsive status epilepticus in comatose patients?

    <p>Damaging to brain tissue</p> Signup and view all the answers

    What should neurodiagnostic technologists be proficient at recognizing in ICU cEEG monitoring?

    <p>Artifacts</p> Signup and view all the answers

    What is the recommended number of electrodes to use in ICU-CEEG monitoring?

    <p>10-20 electrodes</p> Signup and view all the answers

    What is the purpose of this paper?

    <p>To examine the use and benefits of EEG monitoring of ICU patients</p> Signup and view all the answers

    What is the purpose of documenting the patient's current blood pressure, oxygen saturation, and core body temperature?

    <p>To provide a complete picture of the patient's condition</p> Signup and view all the answers

    What should be done to eliminate artifacts caused by muscle activity in ICU cEEG monitoring?

    <p>Administer neuromuscular junction blockade</p> Signup and view all the answers

    What is the primary indication for the use of cEEG in ICU patients?

    <p>Assessment of coma and brain death</p> Signup and view all the answers

    What is the benefit of early intervention in ICU patients with seizures?

    <p>Preservation of brain function</p> Signup and view all the answers

    What is the significance of EEG changes in ICU monitoring?

    <p>They are a sign of neurologic complications requiring intervention</p> Signup and view all the answers

    What is a consideration when selecting electrodes for cEEG monitoring in the ICU?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of testing reactivity to intense stimuli in ICU-CEEG monitoring?

    <p>To assess the patient's level of consciousness</p> Signup and view all the answers

    What is the purpose of setting the LF to 0.3 Hz in Figure 11?

    <p>To record delta activity</p> Signup and view all the answers

    What is the significance of continuous EEG monitoring in ICU patients?

    <p>It provides a unique potential to recognize secondary insults and offers an opportunity for early intervention</p> Signup and view all the answers

    What is the primary concern in ICU patients with nonconvulsive seizures and nonconvulsive status epilepticus?

    <p>Rapid control of seizures to preserve brain function</p> Signup and view all the answers

    What should neurodiagnostic technologists be able to do once an artifact is identified in ICU cEEG monitoring?

    <p>All of the above</p> Signup and view all the answers

    What is the significance of using electrodes with impedances below 10,000 ohms?

    <p>To increase EEG signal quality</p> Signup and view all the answers

    Study Notes

    ICU-cEEG Monitoring

    • The use of EEG as a monitoring tool in the ICU affords many potential benefits, including the identification of seizures, vasospasm following subarachnoid hemorrhage (SAH), and the assessment of coma and brain death.
    • Continuous EEG (cEEG) monitoring provides a unique potential to recognize secondary insults and offers an opportunity for early intervention.

    Indications for cEEG Monitoring

    • Seizures, non-convulsive seizures (NCS), and non-convulsive status epilepticus (NCSE) are damaging to brain tissue, thus rapid control of seizures is essential to preserving brain function.
    • EEG monitoring helps guide the choice of medications most effective for the patient's seizures.
    • An electrographic seizure is defined by a repetitive and evolving pattern with a minimum 2 µV voltage and duration of at least 10 seconds.

    Encephalopathy and Coma

    • The EEG contains clues that are helpful in determining the nature of an encephalopathy or coma and provides clues regarding the patient's prognosis or response to therapy.
    • Slowing of the EEG background activity is the usual pattern associated with impaired cerebral function.
    • Unfavorable prognostic factors include isoelectric pattern, burst suppression pattern, periodic patterns, and electrographic seizures.
    • Favorable prognostic features include background continuity, spontaneous variability, reactivity to stimulation, and presence of normal sleep patterns.

    ICU-CEEG Monitoring Techniques

    • Recommendations for EEG recordings include using a complete complement of 10-20 electrodes, montages of electrodes at least 10 cm apart, increasing the sensitivity to 2 µV/mm, and using appropriate filter settings.
    • Documenting all medications the patient is currently taking, as well as the patient's current blood pressure, oxygen saturation, and core body temperature is essential.

    Technical and Safety Protocols

    • The Neurodiagnostic technologist should select the electrode application method that is most appropriate to the patient's clinical situation.
    • Critical care monitoring programs should consider the electrode cost, ease of use, time for application, imaging compatibility, durability, and recording characteristics when selecting electrodes.
    • Neurodiagnostic technologists who perform cEEG in the ICU should be extensively trained and credentialed, and proficient at recognizing and eliminating artifacts.

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    Related Documents

    ICU cEEG Monitoring PDF

    Description

    Learn about the benefits and indications of using continuous EEG (cEEG) monitoring in Intensive Care Units (ICUs), including seizure identification and coma assessment.

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