Improving the ability of ED physicians to identify subclinical/electrographic seizures on EEG after a brief training module

Chari, G., Yadav, K., Nishijima, D., Omurtag, A. ORCID: 0000-0002-3773-8506 and Zehtabchi, S., 2019. Improving the ability of ED physicians to identify subclinical/electrographic seizures on EEG after a brief training module. International Journal of Emergency Medicine, 12 (1): 11. ISSN 1865-1372

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Background: Approximately 5% of emergency department (ED) patients with altered mental status (AMS) have non-convulsive seizures (NCS). Patients with NCS should be diagnosed with EEG as soon as possible to initiate antiepileptic treatment. Since ED physicians encounter such patients first in the ED, they should be familiar with general EEG principles as well as the EEG patterns of NCS/NCSE. We evaluated the utility of a brief training module in enhancing the ED physicians’ ability to identify seizures on EEG.

Methods: This was a randomized controlled trial conducted in three academic institutions. A slide presentation was developed describing the basic principles of EEG including EEG recording techniques, followed by characteristics of normal and abnormal patterns, the goal of which was to familiarize the participants with EEG seizure patterns. We enrolled board-certified emergency medicine physicians into the trial. Subjects were randomized to control or intervention groups. Participants allocated to the intervention group received a self-learning training module and were asked to take a quiz of EEG snapshots after reviewing the presentation, while the control group took the quiz without the training.

Results: A total of 30 emergency physicians were enrolled (10 per site, with 15 controls and 15 interventions). Participants were 52% male with median years of practice of 9.5 years (3, 14). The percentage of correct answers in the intervention group (65%, 63% and 75%) was significantly different (p = 0.002) from that of control group (50%, 45% and 60%).

Conclusions: A brief self-learning training module improved the ability of emergency physicians in identifying EEG seizure patterns.

Item Type: Journal article
Publication Title: International Journal of Emergency Medicine
Creators: Chari, G., Yadav, K., Nishijima, D., Omurtag, A. and Zehtabchi, S.
Publisher: Springer New York
Date: 27 March 2019
Volume: 12
Number: 1
ISSN: 1865-1372
228Publisher Item Identifier
Rights: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Divisions: Schools > School of Science and Technology
Record created by: Jonathan Gallacher
Date Added: 11 Apr 2019 15:35
Last Modified: 11 Apr 2019 15:36

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