The goal of epilepsy monitoring is to capture several seizures, utilizing continuous electroencephalography (EEG)/video for later analysis. Various provocative techniques. such as withdrawing antiepileptic drugs or sleep deprivation are used to precipitate seizures. Patients run a higher risk of injuries due to having an increase in seizure frequency and/or intensity or a change in seizure type. Evaluating the potential for, and preventing injuries is an important part of risk management. However, very little information has been published regarding safety issues in an epilepsy monitoring unit (EMU).
Several types of safety issues have been identified during monitoring: uncontrolled behavior (ictal and post-ictal aggression, self injurious behavior, psychosis); seizure related injuries (falls, status epilepticus); problems related to electrodes (pulling out scalp and surgically implanted electrodes); and specific concerns regarding children in the EMU. Use of restraints and sitters in selected patients, appropriate medication for psychosis. shock absorbing carpet and “childproofing” rooms for the young are among the preventative actions discussed. Central to risk management is the education of the staff in the assessment of each patient's potential for injury and use the appropriate interventions. Consideration should be given to balancing the need to avert harm. with an unrestricted environment.
Questions or comments about this article may be directed to: Pamela T. Sanders RN. BA. MS, RR1 Box 1844 Preston Road. New Freedom, Pennsylvania 17349 She is the Research Coordinator in The Johns Hopkins Epilepsy Center at The Johns Hopkins Hospital in Baltimore, Maryland.
Barbara J. Cysyk RN. BSN, is the Epilepsy Monitoring Unit Nursing Coordinator at The Johns Hopkins Hospital in Baltimore. Maryland.
Mary Alice Bare RN, BS, MSPH, EEG.T. is an Epilepsy Specialist and Administrator for Long-Term EEG Video Monitoring Program in the Department of Neurology at the Children's Hospital Medical Center in Cincinnati, Ohio.
© 1996 American Association of Neuroscience Nurses