Guterman Elan L, Mercer Mary P, Wood Andrew J, Amorim Edilberto, Kleen Jonathan K, Gerard Daniel, Kellison Colleen, Yamashita Scott, Auerbach Benjamin, Joshi Nikita, Sporer Karl A
Department of Neurology University of California San Francisco California USA.
Philip R. Lee Institute for Health Policy Studies University of California San Francisco California USA.
J Am Coll Emerg Physicians Open. 2024 Sep 13;5(5):e13303. doi: 10.1002/emp2.13303. eCollection 2024 Oct.
Point-of-care electroencephalography (EEG) devices can be rapidly applied and do not require specialized technologists, creating new opportunities to use EEG during prehospital care. We evaluated the feasibility of point-of-care EEG during ambulance transport for 911 calls.
This mixed-methods study was conducted between May 28, 2022 and October 28, 2023. Emergency Medical Services (EMS) clinicians identified eligible individuals, provided emergent treatment, applied EEG, and obtained an EEG recording during ambulance transport. Eligible patients were aged 6 years or older and evaluated for seizure, stroke, or altered mental status. EMS clinicians completed a survey and a brief phone interview following every enrollment. Two epileptologists reviewed EEG recordings for interpretability and artifact.
There were 34 prehospital encounters in which EEG was applied. Patients had a mean age of 69 years, and 15 (44%) were female. EEG recordings had a median duration of 10 min 30 s. It took EMS clinicians an average of 2.5 min to apply the device and begin EEG recording. There were 14 (47%) recordings where clinicians achieved a high-quality connection for all 10 electrodes and 32 (94%) recordings that were sufficient in quality to interpret. There were 24 (71%) recordings with six or more channels free of artifact for 5 min or more. All clinicians agreed or strongly agreed that the device was easy to use.
Among real-world prehospital encounters for patients with neurologic symptoms, point-of-care EEG was rapidly applied and yielded EEG recordings that could be used for clinical interpretation, demonstrating the feasibility of point-of-care EEG in future prehospital care.
即时护理脑电图（EEG）设备应用迅速，且无需专业技术人员操作，为在院前护理中使用脑电图创造了新机会。我们评估了在急救电话响应的救护车转运过程中进行即时护理脑电图检查的可行性。
这项混合方法研究于2022年5月28日至2023年10月28日进行。紧急医疗服务（EMS）临床医生识别符合条件的个体，提供紧急治疗，应用脑电图设备，并在救护车转运期间获取脑电图记录。符合条件的患者年龄在6岁及以上，因癫痫、中风或精神状态改变接受评估。每次登记后，EMS临床医生完成一份调查问卷和一次简短的电话访谈。两名癫痫专家对脑电图记录进行可解释性和伪迹审查。
共进行了34次院前脑电图检查。患者的平均年龄为69岁，其中15名（44%）为女性。脑电图记录的中位数时长为10分30秒。EMS临床医生平均花费2.5分钟应用设备并开始脑电图记录。在14份（47%）记录中，临床医生为所有10个电极都实现了高质量连接，32份（94%）记录的质量足以进行解读。有24份（71%）记录中，六个或更多通道在5分钟或更长时间内无伪迹。所有临床医生都同意或强烈同意该设备易于使用。
在现实世界中对有神经系统症状患者的院前救治过程中，即时护理脑电图检查应用迅速，获得的脑电图记录可用于临床解读，证明了即时护理脑电图在未来院前护理中的可行性。
