Ceribell Use in the Emergent Hospital Setting: Educating Non-Neurologists on its appropriate use, a Quality Improvement Project
Lauren Hatcher1, LynnMarie Jarrat1, Annapoorna Bhat2
1Neurology, University of New Mexico, 2Neurology, University of New Mexico School of Medicine
Objective:
To educate non-neurologists regarding the appropriate use of Ceribell.
Background:
Ceribell EEG is a new device developed to emergently evaluate for non-convulsive status epilepticus (NCSE) as Formal EEG is not always immediately available. With its growing availability, however, emergency providers have opted for Ceribell over EEG, even in patients not meeting criteria for NCSE. If NCSE is not of concern, providers are urged to opt for a formal EEG to more appropriately guide treatment.
Design/Methods:
Surveys were conducted to establish baseline knowledge on the appropriate use of Ceribell. They were asked 4 questions regarding the likelihood of (1) consulting neurology prior to obtaining a Ceribell, (2) ordering a Ceribell for a patient with suspected NCSE, (3) obtaining a Ceribell for abnormal movements, and (4) obtaining a Ceribell for convulsive status epilepticus. Answers were based on a scale of 1-10 with 10 indicating “very likely.” Following this, education was provided regarding the preferred use of Ceribell, with patients in NCSE being prioritized. Two months following this, repeat surveys were conducted for comparison.
Results:
A total of 25 and 26 providers were interviewed pre and post-education, respectively. Their responses averaged a 4.96 regarding the likelihood of involving neurology when considering a Ceribell, which decreased to 3.88 post-education. They also responded an average of 7.44 for the likelihood of ordering a Ceribell for suspected NCSE (8.11 post-education), an average of 5.44 regarding the likelihood of obtaining a Ceribell for abnormal movements (6.23 post-education), and an average of 5.4 for obtaining a Ceribell for status epilepticus (6.58 post-education).
Conclusions:
These results seem to indicate that education is insufficient in educating non-neurologists on the appropriate use of Ceribell and suggest that other means may be necessary to reduce inappropriate Ceribell use (i.e. ordering algorithms), which adds additional patient costs and epileptologist burden.