Performing EEG studies

Performing EEG Studies

An electroencephalogram (EEG) is a non-invasive test that measures electrical activity in the brain using surface electrodes. EEG is essential for evaluating seizures, sleep disorders, and other neurological conditions. After acquiring the EEG, results must be documented and stored in the system for neurologist interpretation.

Before you start

• The patient must have an active EEG order in the system.
• You must be a certified EEG technologist or trained EEG operator.
• Ensure the EEG machine is functioning properly and calibrated.
• Confirm the EEG type ordered (routine, sleep, ambulatory) and duration.
• Prepare the patient by explaining the procedure, expected duration, and any special instructions.
• For sleep EEG, confirm patient cooperation with sleep deprivation or sleep medication protocols if applicable.

Steps

1. Navigate to the Diagnostics & Laboratory section and locate the pending EEG order. Open in Usystems

2. Verify patient identity using two identifiers.

3. Explain the procedure to the patient:

   • The test is painless and non-invasive; electrodes are placed on the scalp to measure brain activity.
   • No electrical current is delivered to the brain.
   • The examination usually lasts 20–60 minutes depending on protocol.
   • Ask about comfort level and arrange pillows or support as needed.

4. Prepare the patient:

   • Have the patient sit in a reclining chair or lie on an EEG table.
   • Position electrodes according to the standard 10-20 system or your facility's protocol:
     • Clean the scalp lightly if needed (mild abrasion to reduce impedance).
     • Apply conductive paste or gel at each electrode site.
     • Secure electrodes firmly but comfortably using adhesive or straps.

5. Connect the electrode leads to the EEG amplifier and verify impedance is within acceptable range (usually <5 kΩ per electrode). Adjust electrode placement if impedance is too high.

6. Calibrate the machine and ensure all channels are functioning properly.

7. Perform the EEG recording:

   • Start recording baseline activity with the patient at rest, eyes closed.
   • Document baseline activity and note the patient's state (alert, drowsy, asleep).
   • Perform activation procedures as ordered:
     • Hyperventilation (usually 3–5 minutes of rapid, deep breathing).
     • Photic stimulation (flashing light at varying frequencies).
     • Sleep induction (if sleep EEG is ordered).
   • Monitor the patient throughout the recording for safety and comfort.
   • Observe and note any seizures, abnormal movements, or behavioral changes.

8. Document behavioral observations:

   • Record when the patient was awake, drowsy, or sleeping.
   • Note any seizures, myoclonic jerks, or other abnormal activity.
   • Document patient cooperation and any technical issues.

9. Once the recording is complete, document the study in the system:

   • Mark the study as Complete or Performed.
   • Record the date, time, and duration of the recording.
   • Note the type of EEG (routine, sleep, ambulatory, etc.).
   • Specify which activation procedures were performed (hyperventilation, photic stimulation, sleep induction).
   • Document baseline rhythms and any abnormal findings noted during recording.
   • Add any behavioral observations or patient-reported symptoms.
   • Note technical quality and any impedance issues that were resolved.

10. Save the study. EEG data is archived and made available for neurologist interpretation.

What happens next

• The EEG recording is stored in the patient's medical record and archived system.
• A neurologist reviews the EEG and writes an interpretation report.
• The report is added to the patient's medical record.
• The ordering physician is notified that results are ready.

Tips & common mistakes

• Patient comfort is important: an anxious or uncomfortable patient may produce artifact or not cooperate with activation procedures; explain the procedure clearly and be reassuring.
• Electrode placement is critical: poor electrode contact or improper placement results in artifact-laden recordings; take time to ensure proper impedance and secure placement.
• Watch for seizures: if the patient has a seizure during the recording, note the exact time and duration, and be prepared to intervene if medically necessary.
• Document everything: thorough documentation of behavioral observations and technical details helps the neurologist interpret the EEG accurately.