ASET Position Statement on the Best Practices in Remote Continuous EEG (cEEG) Monitoring.

The efficacy of continuous EEG (cEEG) monitoring of critically ill patients admitted to the intensive care unit (ICU) and patients admitted to the epilepsy monitoring unit (EMU) has been recognized by physicians, demonstrated by researchers, and described in the American Clinical Neurophysiology Society (ACNS), International League Against Epilepsy (ILAE), and International Federation of Clinical Neurophysiology (IFCN) guidelines (Claassen et al. 2013; Herman et al. 2015; Tatum et al. 2022). cEEG monitoring provides the ability to make real-time treatment decisions, improving patient safety and outcomes and reducing risk (Hill et al. 2019; Rosetti et al. 2020; Claassen et al. 2006; Friedman, Claassen, Hirsch 2009; Classen et al. 2013; Kubota et al. 2018). Qualified personnel must be available to recognize, document and communicate EEG changes and seizures in real time 24/7/ 365. Hospitals may be unable to provide continuous monitoring due to a lack of available onsite staffing, equipment, and other resources, so they often outsource cEEG monitoring services to a qualified and dependable remote service provider (RSP). Guidelines, policies, and procedures for on-site cEEG monitoring are currently available through the ACNS, ILAE, and IFCN (ACNS 2008; Tatum et al. 2022) and ASET (ASET 2011a, 2011b, 2016a), but there are unique aspects related to RSP services that require additional consideration. These unique challenges are addressed in this best practices position statement.