To determine if the portable Ceribell® electroencephalograph (EEG) (Mountainview, CA) used for suspected status epilepticus (SE) can reduce time to diagnosis and on-call workforce demands and if it can be applied to patients in respiratory isolation.

Status epilepticus (SE) is an emergency neurologic disorder whose outcome is based on rapid diagnosis and treatment within a 30-minute time frame. Shortening time to diagnosis is based on 1) clinical suspicion and 2) electroencephalographic interpretation consistent with the diagnosis.  Standard EEG is deployed by a small staff of technicians who provide 24/7 coverage. The device is space consuming and must be brought into isolation rooms. The after-hours on-call response time may be as long as 3 hours. Thus, meeting time-to-treatment windows in community hospitals, with their practical limits on resources, poses an important challenge for treating this neurologic disorder.

We developed a protocol for use of the Ceribell EEG. The staff deploying the device, attending physician, and interpreting neurologist completed evaluation tools for each patient. Data maintained for quality and resource planning of standard EEG ordered for suspected SE were used as controls. Times to diagnosis were compared by Welch-Satterthwaite tests and workforce call-in demands by Fisher’s exact T-test. We evaluated qualitative data related to the use of the EEG in COVID-19 isolation rooms, on its technical aspects and acceptance by staff members.

The Ceribell EEG reduced diagnosis time (p=0.0000006) and on-call workforce demand (p=0.02). The device can be used any time of day in any hospital care area and has advantages in respiratory isolation rooms.

Compared with a standard 18-channel EEG, the Ceribell device allowed earlier diagnosis of SE and non-SE conditions and reduced workforce demands. Due to the ease of its use and its simple components, which can be readily disinfected, it is advantageous for COVID-19 patients in isolation.