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The
Epilepsy Monitoring Unit (EMU) is a specialized four-bed inpatient unit
at The Johns Hopkins Hospital designed to evaluate, diagnose, and treat
seizures in patients of all ages.
Staffed with specially trained medical, nursing, and technical personnel
monitoring patients 24 hours a day, the EMU is equipped with computer-based
monitoring equipment expressly designed for the evaluation of seizure disorders.
Based on this evaluation, treatment options can be determined.
Patients who suffer from seizures which are difficult to diagnose and to
manage are those most likely to be admitted to the EMU. Others are those
who are being considered for seizure surgery who need to be monitored to
locate where in the brain the seizures begin.
Neurologists, neurosurgeons, nurse specialists, EMU technicians, residents,
medical students, nursing students, psychologists, counselors, and social
workers all are involved in the care of each EMU patient. Patients are cared
for by their own primary nurse who is responsible for the planning and coordination
of their nursing care. Computer specialists and biomedical engineers who
supervise the functioning of the monitoring equipment are also members of
the EMU team.
EMU ADMISSION
Certain criteria must be met and steps followed before
admission to the EMU can take place:
- Typically, patients first will
have an initial outpatient consultation with a physician in the Johns
Hopkins Neurological Consultation Center. If appropriate, an admission
will then be scheduled. Referring physicians will receive a full report
from the patient's EMU neurologist after discharge.
- Once the decision has been made
and the admission scheduled, all patients should report to the hospital's
main admitting office between 9:00 a.m. and 10:00 a.m. on the day of
the scheduled admission. The admission process may take two hours or
more.
WHAT
TO EXPECT
In the EMU, seizures
are recorded and studied so that proper diagnosis can be made and treatment
can begin.
Patients who take medication to control seizures may have their dosage
adjusted or discontinued so that seizures can occur, and be recorded and
analyzed. This will be discussed with each patient before any changes
are made. Patients who feel particularly anxious about this are encouraged
to express their feelings to their doctor and nurse.
Each patient will have a private room with a private bathroom.
Patients will be connected to video and computerized EEG monitoring equipment
continuously (24 hours a day). To ensure adequate video monitoring, overhead
room lights will remain on continuously. Patients who wish to use a sleep
mask should bring one which ties at the back of the head. Although this
lack of privacy is bothersome to some patients, continuous monitoring
is necessary to help safeguard patients and gather the needed information.
Because the EEG wires are connected to recording equipment, mobility is
restricted and patients should expect to spend most of their time sitting
in bed or in a nearby chair. Because the electrodes will remain on the
patient's head, patients will not be able to wash their hair or shower
until the monitoring is completed.
Patients who experience an aura, a warning which sometimes occurs prior
to a seizure, should report this to an EMU staff member. Patients or their
visitors should also notify staff of each seizure they suspect as it occurs.
This can be done by describing out loud what is occurring as it occurs
since microphones are placed in each room. This taped information is important
for the analysis of the event. There is also a "button" at the bedside
which signals the EMU staff and the monitoring computers that a seizure
is occurring. This button should be pressed as soon as a seizure begins.
The anticipated length of stay in the EMU varies with each patient, depending
upon the tests and monitoring required and the number of seizures each
patient experiences. Typically, however, patients stay between three days
and two weeks. After discharge from the EMU, some patients remain in the
hospital for a day or two to regulate blood levels and re-adjust to seizure
medications.
WHAT
TO BRING TO THE EMU
Patients should bring with them all medicines they
currently take, including non-seizure medications. These medicines will
be reviewed upon admission.
While patients are in the EMU, they are encouraged to wear their own loose
fitting street clothes (no pullover tops), unless they have been advised
otherwise. Patients should also bring prsonal care items from home as
well as games, books, and crafts to help pass the time. A lending library
for patients is available in the hospital. The television in each room
can be rented. A VCR is also available free of charge to patients who
provide their own tapes.
Parents of young patients may find it helpful to bring special toys or
a blanket to help their child feel more comfortable.
VISITING
HOURS
Regular hospital visiting hours are noon until
8:00 p.m. Each patient is limited to two visitors at one time.
Family members are encouraged to spend as much time as they wish with
the patient including overnight stays. If the patient has special needs
or is a very young child, one family member should plan staying with the
patient and remaining in the patient's room overnight every night the
patient is there. A cot will be provided.
The Head Nurse or EMU Staff Assistant can answer questions regarding visiting
privileges.
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