EEG Monitoring Clinical Pathway — PICU, N/IICU, and CICU

Staff Roles, Responsibilities and Documentation

Throughout EEG monitoring, ICU MD/APP, EEG Technologist, and NeuroICU Consultation Service regularly discuss patient management goals.

NeuroICU Consultation service communicates EEG results to ICU MD/APP.

Phase of EEG Monitoring	Staff Roles and Responsibilities	EHR Documentation
Requesting Initiation	ICU MD/APP Use ICU EEG Monitoring order set to order EEG monitoring and on-call anti-seizure medications Consult NeuroICU Consultation Service ICU MD/APP/RN Secure chat EEG Technologist to: Inform them order placed Confirm no immediate transport off floor is required Confirm ready for EEG initiation NeuroICU Consultation Service Perform consult, including development of Seizure Action Plan with ICU MD/APP EEG Technologist Obtain clinical information from EEG order, additional chart review, or discussion with ICU team	ICU EEG Monitoring order set is embedded in the following order sets Cardiac Arrest Traumatic Brain Injury Status Epilepticus Neo HIE NeuroICU Consultation Service Seizure Action Plan Neurology Consultation Note
Hookup	EEG Technologist and ICU RN Apply electrodes Provide ICU RN EEG monitoring education Connect to multi-modal device and adjust for NIRS if requested PICU RN Complete Initiation Checklist	EEG Technologist Add child to LTM List Initiate EEG Report EEG initiation date/time in EEG flowsheet
Active Monitoring/ Management	NeuroICU Consultation Service Establish management goals with ICU MD/APP and EEG Technologist Convey non-urgent EEG data to ICU MD/APP on at least daily basis EEG Technologist Work with ICU RN to perform reactivity testing as needed Create and update EEG Report template daily Screen EEG ICU MD/APP If concern for seizure, secure chat EEG Technologist to obtain an interval review Neurology EEG MD Screen EEG Perform final interpretation using EEG Report Around-the-clock support for EEG Technologists Collaborate with NeuroICU Consultation Service regarding management at least daily, and more often as clinically indicated	EEG Technologist EEG report updates EEG flowsheet updates as needed Neurology EEG MD Daily EEG report
Seizure or Urgent Result Notification	Initial Seizure(s) PICU EEG Technologist notifies Fellow/APP (not resident) PICU MD/APP implements Seizure Action Plan and involves NeuroICU Consultation Service N/IICU and CICU EEG Technologist notifies NeuroICU Consultation Service Subsequent Seizure(s) All ICUs EEG Technologist notifies NeuroICU Consultation Service
Discontinuation	ICU MD/APP Provide clearance before discontinuation EEG Technologist Perform final EEG screen, up to present, before discontinuation PICU RN Complete Disconnect Checklist	EEG Technologist EEG end date/time in EEG flowsheet Neurology EEG MD Final EEG report

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway, please contact us.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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EEG Monitoring Clinical Pathway — PICU, N/IICU, and CICU

Staff Roles, Responsibilities and Documentation

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EEG Monitoring Clinical Pathway, PICU, N/IICU and CICU – Staff Roles, Responsibilities and Documentation

EEG Monitoring Clinical Pathway — PICU, N/IICU, and CICU

Staff Roles, Responsibilities and Documentation