Neurological emergency medicine, alongside surgery and internal medicine, has become the third most important area in hospital emergency admission [i]. According to the World Health Organization, 15 million people suffer a stroke worldwide each year. Other neurological emergencies that paramedics and medical personnel in emergency rooms and clinics are regularly confronted with include epileptic seizures, cerebral haemorrhages, or traumatic brain injuries. Electroencephalography (EEG) provides the basis for diagnostic decision-making for the treatment. However, speedy EEG examinations have hitherto been associated with a whole series of challenges – especially in emergency and acute medicine. Bittium has tackled these challenges with the new BrainStatus™ EEG solution, which employs a new generation of electrodes, paired with analysis functions based on artificial intelligence (AI).New EEG Electrode Significantly Speeds Up Starting the Measurements
The biggest challenge, in carrying out an EEG quickly, is the application of the electrodes. For conventional medical EEG devices 20 or more electrodes have to be applied over the entire head of the patient, with special care to ensure skin contact in the areas covered by hair. A practiced EEG-MTA usually needs about 20 minutes to attach the electrodes – or still 10 minutes for an EEG cap. This causes two major problems: the time factor, which plays a decisive role in emergency medicine, and the need to have access to specially trained staff at all times. Ambulances cannot be equipped with specialists for all possible medical incidents, and EEG-MTAs and neurologists cannot be even on-site in emergency rooms 24 hours a day either.
Bittium developed a new electrode system with technology from the field of wearables. As part of the medtech solution BrainStatus™, a band with a limited number of electrodes, which are applied to the hairless area in front the head, can deliver precise EEG signals. The electrodes do not have to be attached individually, and the exact positioning is already specified.
The advantages are obvious: the electrodes can be attached much faster, and it is so uncomplicated that paramedics and emergency personnel can derive an EEG without special training.EEG Without Mobility Restrains
Another disadvantage of previous EEG electrodes was their complex wiring, which hindered treatment, especially in emergency medicine. In an emergency room, several doctors and medical personnel often have to treat the patient at the same time. An EEG system with conventional electrodes, which are connected to a monitor via cables, is very cumbersome. The systems were even less suitable for ambulances and patient transport.
Bittium used technology known from wearables to design the mobile EEG BrainStatus™. The electrode band is connected directly to a very compact transmitter that displays the signals wirelessly on a monitor, without impairing the mobility of the patient. This transmission ensures high signal quality and also enables long-term EEG measurements.
Simplified Data Analysis with AI Technology
Traditionally EEG recording is monitored visually and up to now, the data could only be evaluated by trained specialists and was very time intensive.
The specialists don't usually have the time to sit next to a patient for a long period of time to view the recordings in real-time. In the retrospective evaluation, large amounts of records had to be checked and evaluated in order to identify deviations and new incidents. Since the patients are mostly sedated, this also causes the risk that no one would notice another attack.
This topic is not only relevant for emergency and intensive care medicine, but also for long-term monitoring of patients with migraine headaches or sleep disorders.
BrainStatus™ meets this challenge by applying intelligent algorithms to analyze the EEG recordings. While this cannot replace neurologists or trained MTAs, it is a great relief and time-saving measurement the medical staff benefits from enormously when it comes to patient care.
The AI functions evaluate the EEG recordings to create an overview of the recorded data and evaluate trends. Based on this simplified data display on an easy to use tablet, the staff can immediately see if all values are in the “green zone" or if there has been a new incident recently. If the values are outside the norm, the responsible doctor or a specialist can be consulted immediately to take a closer look at the corresponding more detailed recordings and measurements.
The system's software covers all of the standard functions of modern EEG systems, and is also easy and intuitive to use for medical and care personnel who are not familiar with EEG software.Remote Monitoring for More Flexibility and Faster Specialist Support
In addition to recording the data in the device's memory, the patient's EEG data can be transferred to a data storage via the clinic network, so that a neurologist can immediately view the recordings and analytics and give instructions from any location in real time. If there is no specialist on-site, the system also enable reviewing by specialist clinics or experts at other locations. This not only saves time in everyday clinical practice – it can also increase the chances of survival in acute emergencies.
Since the device is not only easier to use, but also compact and suitable for mobile use, even rescue workers can apply the EEG electrodes in the field and transfer the data to specialists, instead of just taking standard measures before transport. Remote monitoring for long-term recordings can also be used on an outpatient basis in the future. This would not only make life easier for patients and clinic staff, but also enable cost savings. After applying the electrodes and the compact transmitter, the patients can leave the clinic and, for example, perform a 24-hour EEG recording at home.Author: Mikko Hallanoro, Senior Product Manager, Neuro Products, Bittium