A European survey on current practices in epilepsy monitoring units and implications for patients' safety

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autorinnen und Autoren: Rubboli G, Beniczky S, Claus S, Canevini MP, Kahane P, Stefan H, Boas WVE, Velis D, Reus E, Gil-Nagel A, Steinhoff BJ, Trinka E, Ryvlin P
Zeitschrift: Epilepsy and Behavior
Jahr der Veröffentlichung: 2015
Band: 44
Seitenbereich: 179-84
ISSN: 1525-5050


Abstract


This study aimed to survey current practices in European epilepsy monitoring units (EMUs) with emphasis on safety issues.A 37-item questionnaire investigating characteristics and organization of EMUs, including measures for prevention and management of seizure-related serious adverse events (SAEs), was distributed to all identified European EMUs plus one located in Israel (N=150).Forty-eight (32%) EMUs, located in 18 countries, completed the questionnaire. Epilepsy monitoring unit beds are 1-2 in 43%, 3-4 in 34%, and 5-6 in 19% of EMUs; staff physicians are 1-2 in 32%, 3-4 in 34%, and 5-6 in 19% of EMUs. Personnel operating in EMUs include epileptologists (in 69% of EMUs), clinical neurophysiologists trained in epilepsy (in 46% of EMUs), child neurologists (in 35% of EMUs), neurology and clinical neurophysiology residents (in 46% and in 8% of EMUs, respectively), and neurologists not trained in epilepsy (in 27% of EMUs). In 20% of EMUs, patients' observation is only intermittent or during the daytime and primarily carried out by neurophysiology technicians and/or nurses (in 71% of EMUs) or by patients' relatives (in 40% of EMUs). Automatic detection systems for seizures are used in 15%, for body movements in 8%, for oxygen desaturation in 33%, and for ECG abnormalities in 17% of EMUs. Protocols for management of acute seizures are lacking in 27%, of status epilepticus in 21%, and of postictal psychoses in 87% of EMUs. Injury prevention consists of bed protections in 96% of EMUs, whereas antisuffocation pillows are employed in 21%, and environmental protections in monitoring rooms and in bathrooms are implemented in 38% and in 25% of EMUs, respectively. The most common SAEs were status epilepticus reported by 79%, injuries by 73%, and postictal psychoses by 67% of EMUs.All EMUs have faced different types of SAEs. Wide variation in practice patterns and lack of protocols and of precautions to ensure patients' safety might promote the occurrence and severity of SAEs. Our findings highlight the need for standardized and shared protocols for an effective and safe management of patients in EMUs.



FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Stefan, Hermann Prof. Dr.
Medizinische Fakultät


Einrichtungen weiterer Autorinnen und Autoren

Epilepsiezentrum Kork
Filadelfia
Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV)
Paracelsus Medizinische Privatuniversität
Ruber International Hospital
Stichting Epilepsie Instellingen Nederland (SEIN)
Università degli studi di Milano
University of Grenoble Alpes (UGA) / Université de Grenoble


Zitierweisen

APA:
Rubboli, G., Beniczky, S., Claus, S., Canevini, M.P., Kahane, P., Stefan, H.,... Ryvlin, P. (2015). A European survey on current practices in epilepsy monitoring units and implications for patients' safety. Epilepsy and Behavior, 44, 179-84. https://dx.doi.org/10.1016/j.yebeh.2015.02.004

MLA:
Rubboli, Guido, et al. "A European survey on current practices in epilepsy monitoring units and implications for patients' safety." Epilepsy and Behavior 44 (2015): 179-84.

BibTeX: 

Zuletzt aktualisiert 2018-06-10 um 02:40