For young epilepsy patients at Texas Children’s Hospital, the process is part of
electroencephalogram (EEG) testing, which records the electrical activity of the brain to
monitor brain wave activity. The test often leaves patients’ skin red and irritated.
When Joellan Mullen, RN, CCRN, MSN, became a clinical specialist in Texas Children’s
neurosurgery unit in 2012, she found that at least 10 percent of the patients in the epilepsy
monitoring unit developed pressure sores because of their EEG electrodes.
According to the National Institutes of Health (NIH), without treatment, these pressure
ulcers can cause cellulitis, an infection of the skin’s connective tissue. At its most extreme,
the ulcers can cause sepsis, which is life-threatening.
“Everyone just assumed we should expect pressure sores from this
type of procedure,” Mullen said. “Nurses would treat it afterward with
antibiotic ointment, but there was nothing being done to prevent it.”
Every month, some 30 to 40 children are admitted to Texas Children’s epilepsy monitoring
unit. Standard protocol called for technicians to thoroughly clean the children’s skin and
then attach electrodes to the forehead and scalp using surgical glue. As a final measure,
technicians wrapped the scalp with gauze and secured the gauze with surgical tape.
Changing
tactics,
changing
outcomes
Imagine undergoing a medical test that
involves having as many as 20 electrodes
attached to your forehead and scalp for days
at a time. The electrodes are held in place
with adhesive and then wrapped with gauze.
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