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Severe Pediatric Traumatic Brain Injury (TBI), PICU — cEEG Monitoring and Seizure Prophylaxis — Clinical Pathway: Emergency, ICU and Inpatient

Traumatic Brain Injury (TBI) Clinical Pathway — Emergency Department and ICU

cEEG Monitoring & Seizure Prophylaxis

cEEG Monitoring

  • See EEG Monitoring Clinical Pathway
  • Recommend continuous EEG monitoring with CT-compatible electrodes for the first 48 hours of admission.
  • Continue if the patient is under neuromuscular blockade.
  • Consult Neurology and order for seizure action plan.

Seizure Prophylaxis Recommendations

Recommend Levetiracetam or Fosphenytoin for initial prophylaxis.

  • Strongly consider anticonvulsant prophylaxis during the 1st week and for infants and children, especially with:
    • Hemorrhage
    • Depressed skull fracture
    • Concern for abusive severe head trauma on CT or if EEG positive (CONSULT NEUROLOGY)
    • < 4 yrs of age

 

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