Handbook of ICU EEG Monitoring

by Suzette LaRoche MD (Editor)

Overview

The emerging technology of continuous EEG monitoring in intensive care units gives practitioners the ability to identify malignant EEG patterns quickly and provide more effective care. Handbook of ICU EEG Monitoring encompasses the wide range of technical and clinical issues involved in the successful monitoring of critically ill patients to detect significant changes in cerebral function and prevent serious neuronal injury. Divided into five sections, the handbook covers EEG acquisition and other technical considerations, clinical indications, EEG interpretation, appropriate treatment, and practical and administrative concerns.

The book addresses the often overlooked subjects of billing, coding, and generating reports to facilitate communication across the entire ICU team. Written by leading experts in this rapidly evolving field, the chapters are brief and formatted for maximum utility with bulleted text, pearls, and take-home points to reinforce key information. High-quality examples of routine and quantitative EEG findings help users hone their interpretive understanding and build skills for detecting clinically significant EEG changes in the ICU.

Handbook of ICU EEG Monitoring Features:

• Broad but practical reference covering all aspects of ICU EEG monitoring
• Thorough discussion of the indications for ICU EEG monitoring and prevalence of seizures in patient subgroups
• Focus on the challenges of EEG interpretation that are unique to EEG monitoring in the ICU
• Pearls and take-home points highlighted in every chapter
• Includes hard-to-find information on technical aspects, indications, billing and coding, and other administrative and procedural concerns

Handbook of ICU EEG Monitoring is the first practical but comprehensive resource dedicated to the art and science of EEG monitoring in the ICU. Neurologists, neurointensivists, neurosurgeons, nursing staff, EEG technologists, and anyone caring for critically patients will find pertinent and pivotal information to inform their practice.

Product Details

ISBN-13:	9781617050787
Publisher:	Springer Publishing Company
Publication date:	12/20/2012
Sold by:	Barnes & Noble
Format:	eBook
Pages:	160
File size:	19 MB
Note:	This product may take a few minutes to download.

About the Author

Assistant Professor of Neurology and Director of Neurophysiology, Emory University School of Medicine, Atlanta, GA

Table of Contents

Preface, Suzette M. LaRoche; Part 1: Technical Issues: Chapter 1: EEG Acquisition Equipment, Susan T. Herman; Chapter 2: Electrodes and Montages, John Ives; Chapter 3: Networking and Remote Monitoring, Andrew Ehrenberg; Chapter 4: Data Storage, Andrew Ehrenberg; Chapter 5: Staffing an ICU Monitoring Unit, Leisha Osborne; Part 2: Indications: Chapter 6: Status Epilepticus, Tom Bleck; Chapter 7: Ischemic Stroke, Wendy Wright; Chapter 8: Subarachnoid Hemorrhage, Adam Webb; Chapter 9: Intracranial Hemorrhage, Lori Shutter; Chapter 10: Encephalitis, Jerzy Szflarski; Chapter 11: Traumatic Brain Injury, William Freeman; Chapter 12: Therapeutic HypothermiaóAdults, Ram Mani; Chapter 13: Therapeutic HypothermiaóPediatrics, Nicholas S. Abend; Chapter 14: Prognosis, Leslie Rudzinski; Chapter 15: EEG Monitoring in the Medical ICU, Stephen Hantus; Chapter 16: Special Considerations for Pediatric Patients, Cecil Hahn; Chapter 17: Special Consideration for Neonatal Patients, Tammy Tsuchida; Part 3: EEG Interpretation: Chapter 18: ACNS Research Terminology, Elizabeth Gerard; Chapter 19: Encephalopathy and Coma, Dan Friedman; Chapter 20: Periodic Lateralized Discharges, Elizabeth Gerard; Chapter 21 Generalized Periodic Discharges, Nathan Fountain; Chapter 22: The Ictal-Interictal Continuum, Suzette M. LaRoche; Chapter 23: Non-convulsive Status Epilepticus, Frank Drislane; Chapter 24: Post-anoxic Encephalopathy, Elizabeth Waterhouse; Chapter 25: EEG Correlates of Ischemia, William Tatum; Chapter 26: Common artifacts in the ICU, Sarah Schmitt; Chapter 27: Quantitative EEG Basic Principles, Saurabh Sinha; Chapter 28: Quantitative EEG Clinical ApplicationóSeizures, Saurabh Sinha; Chapter 29: Quantitative EEG Clinical ApplicationóIschemia, Susan T. Herman; Part 4: Treatment: Chapter 30: Generalized Convulsive Status Epilepticus, Aatif Husain; Chapter 31: Non-convulsive Status Epilepticus, Peter Kaplan; Chapter 32: Status Epilepticus in the Pediatric Population, James Riviello; Chapter 33: Alternative Treatments for Refractory Status Epilepticus, Larry Hirsch; Chapter 34: Prophylaxis of Seizures in the ICU Population, Gretchen Brophy; Part 5: Additional Considerations: Chapter 35: Billing and Coding, Marc Nuwer; Chapter 36: Report Generation and Communication with ICU Team, Stephen Hantus; Chapter 37: Multimodality Monitoring and Depth Electrodes, Jan Claassen; Chapter 38: Future Directions, Larry Hirsch

Editorial Reviews

Reviewer: Junaid Islam, MD (Thomas Jefferson University)
Description: This book is the second edition of this series and offers a unique and through appreciation of the complexity of ICU EEG monitoring. It entails a broad approach to a number of clinical applications for EEGs in the ICU but is primarily dedicated to seizure detection. It represents, in a concise way, the most up to date utility of EEGs in an ICU setting. One of the author's has extensive clinical experience in EEGs and the other other is a recent graduate who offers unique insight with cutting edge understanding of a rapidly emerging field.
Purpose: The function of the book is to guide clinical decision making on when to place an individual on EEG and how to interpret the electrographic patterns in the clinical context. EEGs are becoming much more common place and although they can provide extensive understanding of a neurological disease process they are limited by their availability, expertise in EEG placement and physical space in a compact ICU room. Placing a critically ill patient also limits a physician's ability to perform other tests/procedures that are integral to management and treatment of a patient. To this end it is of crucial importance for neurologists, epileptologists and intensivist to recognize the importance of electrographic monitoring and complications that can arise with EEG use in critically ill patients. The large majority of the book is comprised of interpreting electrographic readings but the underlying tone relates to the necessity of EEG use.
Audience: The intended audience is primarily epileptologist but the information is also applicable to senior neurology residents, general neurology attendings and intensivists. The technical details and the advanced concepts may be outside of the field of scope of knowledge and utility for most students and neurology residents.
Features: The first section of the book starts off with technical details of EEG placement and different montages available for interpretation. It goes into detail explaining the hardware and software necessary for electrographic readings. This section is relevant only to epileptologists and EEG techs. The following section details the need for EEG reading in an ICU setting. The primary indication being status epilepticus but other indications range from , strokes(ischemic and hemorrhagic) to traumatic brain injury to cardiac arrest patients and other indications. It also discusses the usefulness of EEG in patients with altered mental status non-neurologic ICUs(MICU, SICU, CCU, PICU). The following section discusses interpretation of various electrographic readings, including background activity, EEG artifacts, electrographic discharges that are concerning for seizures and electrographic discharges that are isolate. It emphasizes the complexity of making the distinction in the final two categories. The following section provides a detailed account of treatment for various forms of seizures (convulsive, non-convulsive and focal seizures). The following section discuses other various uses and issues that arise with EEG monitoring including billing, discussing results with ICU teams and multimodality monitoring. The book is well written and very thorough. Most parts are very easy to understand even for the lay person. Every topic is broken down into bullet points, which makes it very easy to reference and go back to. This also allows readers time to decompress every point before moving onto the next thought.
Assessment: The handbook of ICU EEG monitoring is a well written and detailed illustration of the utility of EEG monitoring in an ICU setting. Although it is very informative and thorough, the book at times delves too deep into topics and fails to deliver on its title as a "handbook". Other ICU EEG books are much larger and more detailed but this book claims to be a condensed version. It is smaller than most but offers a little too much detail and is physically too large to be what its titles claims. It is a good book, easy to read, with its bullet point format, and effortless to reference but falls short as a "handbook" due to its size and detail.

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