Donna Kerner shares real-world experiences: Impact of Ceribell Rapid Response EEG

Donna Kerner, DNP, is a nurse at North Shore University Hospital in Long Island New York. She shares her experiences with Ceribell from a COVID-19 hotspot during the peak of the pandemic.

“Many cardiac arrest patients who survive the initial event will eventually die because of withdrawal of life-sustaining treatment in the setting of neurological injury… Thus, much of post-arrest care focuses on mitigating injury to the brain.” -Circulation. 2020;142(suppl 2):S366–S468. DOI: 10.1161/CIR.0000000000000916

Prompt EEG is recommended for post-cardiac arrest monitoring and prognostication. Download the guidelines here.

Stephan A. Mayer, MD, FCCM, FCNS, is Director of Neurocritical Care and Emergency Neurology Services at Westchester Medical Center Health Network, and Professor of Neurology and Neurosurgery (pending) at New York Medical College.

Dr Mayer earned his medical degree from Cornell University Medical College in New York City. He completed a residency in neurology and a fellowship in critical care neurology at the Neurological Institute of New York, Columbia-Presbyterian Medical Center. He is board certified in neurology and was a founding member and is a past-president of the Neurocritical Care Society.

Dr. Mayer has published more than 275 original research articles, 200 review articles, 370 abstracts, and written 8 books, including the most recent edition of Merritt’s Textbook of Neurology. His work in helping victims of severe brain injury has been featured in the Wall Street Journal and the book Cheating Death, by CNN medical correspondent Dr. Sanjay Gupta.

Andrea O. Rossetti, MD is the Director of the EEG/Epilepsy Unit at the Department of Clinical Neurosciences the Lausanne University Hospital (CHUV), Switzerland. He received his medical degree from the University of Bern and trained in Lausanne, Bern and Lugano.

After a fellowship at Brigham and Women’s Hospital, Harvard Medical School in Boston, Prof. Rossetti returned to Lausanne, where he has been in charge of the Epileptology / EEG Unit since 2007 and senior physician since 2008.

Prof. Rossetti is an Associate Professor at the Faculty of Biology and Medicine at the University of Lausanne. His main areas of clinical research include the evaluation of the prognosis of acute coma, the diagnosis and management of prolonged seizures (status epilepticus).

Prof. Rossetti has published 211 peer-reviewed articles (121 as first or senior author), and written 12 book chapters and 2 books.

Patients experiencing prolonged seizures are at higher risk of mortality, secondary brain injury, length of stay, and complications. Non-convulsive seizures, which show no outward signs, are a very common medical emergency in severely ill patients, but they can only be diagnosed using electroencephalography (EEG).

Conventional EEG systems are not designed to be readily available for use in critical care situations, often leaving clinicians with no choice but to make treatment decisions without having access to definitive diagnostic information and brain activity.

Our mission is to improve patient outcomes by making EEG tools widely accessible for critical care use so physicians can make more informed clinical decisions for patients at risk for seizures.

Learn more about the Ceribell Rapid Response EEG System solution by watching this short video.

Reduced EEG montage like that used by Ceribell Rapid EEG has a high accuracy for seizure triage in the post cardiac arrest setting

  • A reduced electrode montage may be used for post cardiac arrest EEG monitoring
  • Background patterns were almost perfectly assessed with a reduced montage
  • Discharge patterns were identified with high accuracy

Limited-Montage EEG may be a valuable tool for the detection of nonconvulsive seizures

  • Nonconvulsive seizures were detected with high accuracy using the limited electrode array configuration in hatband (circumferential Ceribell) montage.
  • These findings suggest that in some patients with nonconvulsive seizures, limited-montage EEG may allow to identification of ictal and slow patterns.

The Ceribell EEG System offers rapid EEG acquisition and conversion of EEG signals to sound (sonification) using a proprietary algorithm

  • Ceribell EEG System (1) reliably provided rapid emergent EEG data, (2) accurately identified subclinicial seizures, (3) resulted in fewer non-seizing patients being treated, and (4) was easy to use by clinicians not trained to place or read conventional EEG
  • Mean set up time for Ceribell EEG was 6±3 min
  • Median time from EEG order to Ceribell EEG was 23 min (IQR 14–46) versus 145 min (IQR 93–237) for conventional EEG (p<0.001)
  • On a scale of 1 (very difficult) to 5 (very easy), participating physicians rated the ease of use of the Ceribell headband and the Ceribell EEG recording device as 4.51 ± 0.85 and 4.97 ± 0.17
  • Considering all 35 cases, treatment decision changed in 14 cases (40%)

Hobbs, K. et al. (2018) Rapid Bedside Evaluation of Seizures in the ICU by Listening to the Sound of Brainwaves: A Prospective Observational Clinical Trial of Ceribell’s Brain Stethoscope Function. Neurocrit Care 29(2):302-312. https://doi.org/10.1007/s12028-018-0543-7

Individuals without any prior EEG training can accurately determine whether the EEG represents seizures or nonseizure conditions

  • Individuals without EEG training can detect ongoing seizures or seizure-like rhythmic periodic patterns by listening to sonified EEG
  • Nonexperts listening to single-channel sonified EEGs detected seizures with remarkable sensitivity (students, 98%±5%; nurses, 95%±14%) compared to experts or nonexperts reviewing the same EEGs on visual display (neurologists,88%±11%; students, 76%±19%)
  • Nonexperts listening to sonified EEGs rated them as seizures with high specificity (students, 85%±9%; nurses, 82%±12%) compared to experts or nonexperts viewing the EEGs visually (neurologists, 90%±7%; students, 65%±20%)