Ceribell Case Study:

Highly Epileptiform Patterns in a Post-ROSC Patient 

 

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Patient

64 y/o F w PMH of COPD (on home oxygen), pulmonary hypertension, heart failure w/ preserved ejection fraction, CKD 3, anemia, tobacco use, chronic UTIs, hydronephrosis, prolapsed bladder

Timeline

  • Patient accompanied by husband & EMS to the ED due to AMS. Patient essentially unresponsive. Not following commands. GCS <8
  • CT Head negative
  • Blood cultures negative
  • ABG w/ hypercapnea & respiratory acidosis. AKI.
  • Intubated in ED and went into cardiac arrest
  • Code x 14 minutes (compressions, defibrillation, amiodarone)
  • Placed on a propofol infusion & midazolam 2mg given at 0800
  • Transferred up to ICU, blood and urine cultures negative
  • Ceribell applied at 1243 due to concern for post-anoxic seizure in the ICU​
  • Max seizure burden reached 83.33% at 1830. Neuro confirmed EEG consistent with inter-ictal continuum
  • Levetiracetam 2g and midazolam 2mg given at 1830 and 1900​
  • Midazolam given again at 2020
  • Patient responsive and extubated the following day

Case study is representative of real medical events.