To evaluate the time between the epilepsy monitoring unit (EMU) event button activation (PB) and patient observer’s response.  

The National Association of Epilepsy Centers (NAEC) requires EMU patient observers to always be present to minimize patient injury during their EMU admission. Our current workflow requires verbal response from the patient observer over the speaker to the patient’s room, followed by contacting the nursing staff via the Vocera^TM device. We evaluated the efficiency of our current EMU staffing model in response to PBs.  

This study was approved by institutional IRB. We retrospectively reviewed video EEG files for all available PBs between January 1 and December 31, 2023, in the Adult NAEC-accredited Level 4 Epilepsy Center and calculated the interval between PB and patient observer’s response. Basic patient demographics and event details were collected. Mann-Whitney and Fisher’s exact tests were used for statistical comparisons of groups based on age, sex, and race with a p-value <0.05. 

There were 402 PBs from 129 admissions. The median patient observer response time was 15 seconds (range: 0-780 seconds). The response time increased across age groups (14s, 16s, and 20s for <45, 45-64, and >65 yo, respectively; p=0.027). The response to psychogenic attacks (PNEAs) was faster (average=10s) than to epileptic seizures (average=14s), accidents (average=15s), and other events (average=17s) (p<0.001). There was no difference in response time between sexes (p=0.870) or races (p=0.197). 76% of PBs were self-activated, 14% were activated by family members, 9% by healthcare providers, and 1% could not be specified. Patients initiated PBs in 94% of accidents, 52% of seizures, and 48% of PNEAs. Family members activated 37% of PBs for seizures.