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

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 (2015)

Publication Type: Journal article

Publication year: 2015

Journal

Epilepsy and Behavior Elsevier

Book Volume: 44

Pages Range: 179-84

DOI: 10.1016/j.yebeh.2015.02.004

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.

Authors with CRIS profile

Hermann Stefan Medizinische Fakultät

Involved external institutions

Filadelfia DK Denmark (DK) Stichting Epilepsie Instellingen Nederland (SEIN) NL Netherlands (NL) Università degli studi di Milano IT Italy (IT) University of Grenoble Alpes (UGA) / Université de Grenoble FR France (FR) Ruber International Hospital ES Spain (ES) Epilepsiezentrum Kork DE Germany (DE) Paracelsus Medizinische Privatuniversität AT Austria (AT) Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV) CH Switzerland (CH)

How to cite

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.

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