How to set up a patient for ambulatory EEG at home
By Sandy Penney R. EEG T./RPSGT
Preparing a patient for a successful ambulatory EEG in their home can be an easy process if you are prepared. As brain monitoring technology has improved, EEG machines are no longer excessively heavy and complicated devices. However, setting up the patient for routine, intermittent, or long-term monitoring still requires the expertise of a trained and experienced EEG technologist.
Keep reading to see advice from experienced EEG technologists who have a history of their studies performing without fail.
To do before you visit a patient's home
Do your homework on the patient
Try to find out if your patient has special needs. For example: If you need an interpreter, it would be helpful to know that ahead of time, as the preparation process may require more time. The more information you have, the better. Try to eliminate any unknown factors before you arrive at the patient's home.
Ask yourself these questions before you arrive:
- Will there be pets? Will they need to be separated so I can set up properly?
- Does the patient have cognitive impairments?
- Do I know where I'm setting up? Will I have enough space to do my job?
- How long do I expect the preparations to take?
- Who needs to be there? Will they be filling out any paperwork?
- Will the patient have a clean, accessible head... and will I easily be able to place electrodes on it?
Knowing the answers to these questions can reduce friction when you visit a patient for an in-home ambulatory EEG.
Bring the tools of the trade
Make sure you have plenty of supplies and an area to place them. Many EEG technologists have a premade "kit" that includes typically everything they need, but it's a good idea to bring extra supplies. Ask your patient where you can set up a dedicated space that you have control over. This way, supplies aren't lost and you know exactly where everything is.
Every patient's home will be unfamiliar territory. Have your prep supplies within reach so that set up can be completed as quickly as possible. This can include your computer and EEG monitoring device! If you want to achieve the cleanest recording possible, you can read our guide on how to reduce the appearance of artifacts during an EEG recording in a patient's home.
To do before you start the ambulatory EEG
Ensure the patient's comfort
Asking the patient to wear a button-down shirt before getting prepped will make changing clothes easier for the patient and make sure their head wrap and wires aren't disturbed.
Have the patient sit in a comfortable chair so you have easy access to the top of their head and can move freely around them. This may be their first time getting an aEEG, so listen to their concerns and be compassionate. A positive attitude can be calming!
Try and read your patient's mood when speaking with them. If they enjoy conversation, ask them questions to keep them talking. Some may prefer a more quiet setting, but chances are if they're talking with you or telling a story, they're at ease. Explain what you're doing in an age-appropriate and simple way. Be sure to laugh at their silly jokes that you've heard a hundred times, like: "Are you going to color my hair?" or "You probably won't see any brain waves from me!"
Prepare the Patient
While there is an emphasis on efficiency for the sake of the patient, it is better to take your time. Do it correctly the first time and you won't have to go back and fix something later. "An ounce of prevention is worth a pound of cure."
When applying Nuprep, just erase the center of your "X." Swipe in the same direction, and then apply the lead and repeat. If you use Collodion for more active patients during LTM, make sure you are in a well-ventilated area. Have the wires go toward the nape of your patient's neck or towards the PZ area to make a neat bundle of wires before you begin the head wrap.
Write down some notes regarding what the patient should do if they need you, or if you have instructions that they need to follow. In the event that they forget something, they have a handy guide waiting for them. If they have a diary or journal, explain what kind of notes they should be taking. If their aEEG device has an event button, demonstrate how to use it.
Finally let them know when you intend to be back, if they will need to change batteries themselves, remove wires, or how to return the equipment. Remind them that they shouldn't bathe during the study or get the EEG equipment wet. If something does go wrong, inform the patient who to contact. Give patients some peace of mind while they undergo their in-home study.
And don't forget to check impedances before you wrap!
Perform the EEG head wrap
We have talked about the importance of the head wrap before when it comes to sleeping peacefully during an EEG study. Ideally, the patient won't even notice it's there after a while.
When wrapping the head, go around the circumference of the head twice and then cover any missed areas until completely covered. Use longer pieces of tape to secure the wrap. If you have time to cut the tape into sections before you start the wrap, securing it can be made a little easier.
If a chin strap is necessary, make sure that it's not too tight under the patient's chin. The same advice goes for the head wrap. If wrapped too tightly it can not only be uncomfortable for the patient - it can cause a pressure wound. On the reverse, if the wrap is too loose, electrodes and wires could get pulled off the patient's head.
We hope this helps your EEG studies perform smoothly not just in the home, but anywhere.
If you would like to get more EEG tips or information regarding our products and services, join our mailing list.