It Looks Like Chicken Scratch to Me (or Making the Most of Today’s Technology): A Practical Guide for the Bedside Nurse to Optimize Amplitude-Integrated EEG Monitoring

Abstract

Neurological concerns in the neonate presenting as abnormal electrical activity in the brain can be difficult to identify, yet may have profound lifelong sequelae. Traditional video EEG is the gold standard for diagnosis, but is usually outside the scope of most neonatal providers to interpret. The development of amplitude-integrated electroencephalography (aEEG) gives neonatal providers a unique bedside opportunity to trend and interpret real-time neurologic activity to better care for the infants in the NICU. However, the interpretation is only as reliable as the information the monitor provides. It is critical for the nursing staff to correctly place aEEG monitor leads, assess for proper function, and troubleshoot potential concerns. Based on published information plus my own experiences working with aEEG monitors as well as teaching its use to almost 200 staff nurses in two Level III/IV NICUs, I will present a concise, approachable guide covering lead placement, troubleshooting, and basic interpretation.