About Your Stay:
Epilepsy Monitoring Unit
Handbook for Patients
etmc.org
Table of Contents
ETMC Epilepsy Monitoring Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
What Is an epilepsy monitoring unit (EMU)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Your experienced epilepsy monitoring team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
EMU visiting hours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Preparing for your admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Packing for your EMU stay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Your hospital stay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
What happens when I have an event? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Frequently asked questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Additional information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
East Texas Medical Center
Epilepsy Monitoring Unit
W
elcome to the ETMC Tyler Epilepsy Monitoring
Unit, and thank you for choosing ETMC. Many
of our patients preparing to enter the unit have
questions or mixed emotions or may even be anxious
about their journey and the possibility of having a
seizure. We assure you, this is completely normal.
You are about to take an important step toward a
new life. The experts at the ETMC Epilepsy
Monitoring Unit have carefully planned your care to
help assure your safety during your monitored stay.
You will be in excellent hands.
Facts about the ETMC Epilepsy Monitoring Unit
• We routinely monitor patients just like you. More than 2,600 EEGs were completed last year.
• We take a team approach to caring for you and your family. Each of our team members is specially
trained to take care of patients with seizure disorders. What’s more, we understand that your needs
are unique.
• We provide innovative technologies in our state-of-the-art suites.
What is an epilepsy monitoring unit? Why is it necessary?
The adult epilepsy monitoring unit is a unique area designed for round-the-clock neuro diagnostic
monitoring. Because there are so many different forms of epilepsy, the first step in treating your
condition is to make the right diagnosis. With an understanding of each individual’s seizure condition,
epilepsy specialists with the ETMC Neurological Institute can recommend the best treatment for each
person. Therapies can range from changes in diet to medications to surgical interventions – all with
the goal of reducing the frequency of seizures and improving your quality of life.
The EMU is equipped with state-of-the-art monitoring and diagnostic equipment and features four
private patient rooms with enhanced amenities to make each patient’s stay more relaxed and
comfortable. Family members are welcome and encouraged to remain with you during your stay.
You may be admitted to the ETMC EMU because you have not responded to traditional medication
therapy, your seizure disorder causes a reduced quality of life or your physician is determining
whether your seizures are epileptic or nonepileptic. Long-term continuous monitoring also can help
your physician determine whether you are a surgical candidate.
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Your experienced epilepsy
monitoring team
The epilepsy monitoring unit is staffed 24 hours
a day by physicians, nurses and technologists
specially trained to care for and monitor patients
experiencing seizures.
Neurologists, neurosurgeons, EEG technologists,
case managers and social workers all may be
involved in the care of each EMU patient. Care for each patient begins with the primary nurse,
who is responsible for the planning and coordination of the patient’s nursing care.
Admission to the EMU at ETMC begins when your doctor decides that prolonged video-EEG
monitoring would be useful in evaluating your seizures or epilepsy.
EMU visiting hours
Family members and other close supporters are encouraged to spend as much time with you as
they wish during the day. One support person is encouraged to stay with you overnight.
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Preparing for your
admission
Preregistration
The first step in your journey is to preregister
prior to admission. Your physician’s office will
call the scheduling department at ETMC to get
you registered and scheduled in advance of your admission date to the EMU. When you arrive at the
hospital on the day of admission, you will check in at the front entrance in the admissions department.
You will be asked to verify your information and provide your insurance card.
You should be prepared with the following
• Name and address
• Marital status
• Social Security number
• Insurance information including the name of the primary insurance holder
• Group and policy number from your insurance card
• Employer’s name and address
• Emergency contact person
• Referring physician and/or primary care physician
• Religious preference
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Medications
Medications not to take
Follow your physician’s instructions about reducing or
eliminating your seizure medications to prepare for
admission to the EMU. Contact your physician’s office
if you have any questions about your medications.
Medications to take
Any medications you regularly take that your physician did not specifically mention should be
taken on your usual schedule. Be sure to bring a list of all your home medications with you on
your admission day.
Cessation of smoking
If you smoke, it is necessary for you to quit smoking before your admission to the EMU, as
smoking is not permitted there or anywhere in ETMC Tyler. This hospital admission may provide
the motivation you need in order to quit. Although there is no direct evidence showing that
smoking causes seizures, there are safety concerns you should consider. Seizure patients who
smoke face an increased risk of injury from fire because of the possibility of having a seizure while
smoking. There will be no opportunity to disconnect yourself from the monitors to smoke while
you are in the EMU.
Help in quitting smoking
Most patients find that a formal smoking cessation program works best because it provides the
motivation, accountability and encouragement needed to overcome the addiction. You may wish
to talk with your primary care physician about what program would work best for you.
As you know, it will be tough to quit smoking. But for your safety and overall health, make today
your first of many smoke-free days to come.
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Packing for your EMU stay:
A checklist
Items you may wish to bring
• Comfortable, loose-fitting clothing such as button-up shirts, shorts,
pajamas, bathrobe, boxer shorts and gowns. Button-up,
comfortable shirts are best because of the electrodes and wires
that will be placed on your head.
• Nonskid footwear and a pair of tennis shoes. Your doctor may
have you ride our exercise bike, so you’ll need tennis shoes.
• Enough personal toiletries to last up to five days. Personal items may
include toothpaste, toothbrush, cleansers, tissue and deodorant.
• Eyeglasses, contact lenses and lens case with solution. Please note that eyeglasses and contact lenses
will have to be removed during electrode application.
• Storage container for dentures.
• Walker or crutches labeled with your first and last names.
• A list of all your home medications, vitamins, herbal remedies and dietary supplements you currently
take, including how much you take of each one, how often you take them and the last time you took
them. You also may want to bring the medications in case some are not available in the ETMC pharmacy.
• List of any food or medication allergies you may have and a description of what may happen if you
take them.
• Pillows from home, if you think they would make you more comfortable. Please use distinctive
pillowcases to keep them separate from hospital pillows.
• Any favorite foods or beverages. A refrigerator is available in every room. We offer complimentary
in-room dining to patients from 6:30 a.m. to 8 p.m., as well as in-room dining for the support person
staying with you overnight.
• All applicable insurance cards.
• Your advance directive, either a living will or durable power of attorney for healthcare. If you don’t
have an advance directive, forms are available at the hospital for you to complete.
• This ETMC Epilepsy Monitoring Unit Handbook for Patients.
• Any other items that would help you feel more comfortable, including books, magazines, laptop
computers (free Wi-Fi is available), digital music player, radio or CD player with earbuds (no
over-the-head headphones).
Items you should leave at home
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• Credit cards
• Cash
• Checks
• Valuables of any kind
• Jewelry
Admission
One week before admission
• Check with your admitting physician about stopping
any medications. Your physician should advise you
if and when you should stop any medications.
Day before admission
• Pack your bag for the hospital.
Day of admission
• Take your usual medications, in accordance with your physician’s orders for the EMU.
• Bathe and shampoo your hair before arriving. Dry your hair thoroughly, but do not use any hair spray,
oil, mousse, gel, conditioner or other product on your hair. Remove any hair extensions or braids.
• Wear loose-fitting, comfortable clothing that can be easily removed (a button-up shirt is
recommended).
• Eat breakfast before arriving at the hospital.
• Plan to stay at least five days. Review your packing list to be sure you have what you need. Do not
bring jewelry or valuables.
• Make arrangements for a ride home that may be needed at any time during the stay. Do not plan to
drive yourself, because your medication regimen may be changed, which could make you more
likely to have a seizure.
• Prepare for a smoke-free environment. You will not be able to disconnect yourself from the monitors
to go outside and smoke. You may ask your physician for a nicotine patch, if needed.
• Report to the ETMC Tyler admissions office on time.
Arriving at ETMC Tyler
• Park in one of the designated patient parking areas near the main entrance. Please see the map and
driving directions provided at the back of this guide.
• As you enter the hospital, report directly to the registration/admissions area in the main lobby on
the first floor to check in. Even if you preregistered, bring your insurance card.
• You will receive a wristband with your name, date of birth and physician’s name.
• We strongly suggest you ask your coach, a family member or friend to accompany you.
• The day of your admission will be busy, but a significant amount of time may pass between the time
you check in to the hospital and the time your monitoring begins. Please be prepared for the wait.
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When you arrive
for monitoring in the
ETMC EMU
When you arrive at the ETMC EMU, a nurse
will orient you to the unit and conduct an
admission interview with you. The nurse, a
specialist in epilepsy care, will ask about your past and present medical history, as well as your daily
routines and lifestyle. These questions may seem personal, but they will help us plan your care while
you are in the unit.
A wristband will be placed on you, listing any allergies that you have. It is important for you to verify
that all information on your identification wristband is correct. We will ask you to confirm this
information many times throughout your stay as one way of ensuring your safety.
You also will receive an armband indicating you have the potential to fall. The armband is our way of
affirming that your safety is of the highest importance, and we want all staff members to be aware of
your risk for falling. Your nurse will start an IV during admission to the unit. All EMU patients are
required to have IV access in case of emergency.
An EEG technologist will explain our monitoring and recording procedures to you. The technologist
will connect the various electrodes used to monitor your brain waves. The electrodes will stay in
place on your scalp during your entire stay in the unit. Once the electrodes are in place, they are
connected to recording amplifiers, and the digital video camera is adjusted. All of these devices are
connected to a computer that helps us collect, analyze, save and recall large amounts of data about
your condition. Applying electrodes to your scalp may take one to two hours. You may want to bring
a digital music player or radio with earbuds to use during the extended period of time you will need
to remain still during the application of EEG electrodes.
Once the EEG electrodes are in place, your monitoring will begin. You will have an event button at your
bedside that you will be instructed to press if you feel an event beginning or if your coach or family
member notices an event. You will be able to talk to the technologist monitoring you. It is important
that you immediately notify the technologist if you feel an aura or the beginning of an event.
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You will be asked to sign consent
forms for EEG monitoring. Your EEG
technologist will go over the do’s and
don’ts of the EMU. You will not be
allowed to shower, chew gum, ice or
hard candy, or use tobacco while EEG
electrodes are in place. At least three side rails to your bed must remain up at all times, and all side
rails will be padded for your safety. Patients must be assisted to the restroom at all times.
You will spend several days being monitored. EEG technologists and nurses staff the monitoring unit
to observe patients. Because they can see and hear you, these experts are available to respond when
a seizure occurs. To ensure that we record a seizure while you are in the monitoring unit, it is often
necessary to lower the dosage or stop the anti-convulsant medication(s) you are taking. When
medications are reduced, you may experience different types of seizures, some of which your family
may not have witnessed before. However, our experts will be able to care for you.
If you bring medications to the hospital, we will ask for them to be taken home by your family
member(s) unless the medication is not available in our pharmacy. All medications not taken home
will need to be secured in the medication room. Your physician will give specific orders to the nursing
staff to follow during seizures.
Most of the time you will stay in bed or on a reclining chair next to your bed. You will be
disconnected from the equipment to get up and move about twice a day. Having a staff person
accompany you on all walks is required for your safety, as your medication has been reduced or
discontinued. For your safety, we also limit your walking within the unit itself. When showering, upon
discharge, a staff member needs to be seated in the hallway near the shower for your safety. Bed
baths are offered during the monitoring process. We recommend you wear comfortable clothes such
as button-up, loose-fitting or short-sleeve shirts and shorts or sweatpants. You need not wear a
hospital gown in the unit, but they are available, if needed.
Activities for patients and family members
Patients and family members may bring many different items to the unit to help pass the time. We
suggest puzzles, books, magazines, card games, hand-held computer games, craftwork or hobby
projects such as needlepoint, cross-stitch or embroidery. You also may bring your laptop computer.
Wi-Fi is available with an Internet connection.
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What happens when I have an event?
The nursing staff will be notified immediately in case of an event. Your safety is our highest priority,
and we will take any precautions necessary to ensure that you remain safe. Your EEG technologist
will ask you to remember three words (for example, dog, red, moon). You also will be asked your
name, the date and where you are. Your nursing staff will complete a neurological assessment while
you are having your event and stay with you until the event is over. They will perform a follow-up
neurological assessment once your event has subsided. Your physician will be notified of your event,
and the nursing staff will implement any orders received by the physician.
What happens if I do not have any events?
Different types of interventions may be used to induce events. These include
• Sleep deprivation – Your physician will determine a sleep schedule for you to follow that gives
you a limited amount of sleep.
• Photic stimulation – In this procedure, a light flashes in your eyes for 10 seconds on and 10
seconds off. There are multiple rounds, and the light gets faster each round. The lights will not harm
your eyes. Your eyes may be open or closed.
• Hyperventilation – In this procedure, you will be asked to breathe deeply through the mouth for
approximately three minutes.
• Exercise – Your physician may have you ride an exercise bike for a specified amount of time
while a staff member accompanies you.
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Frequently asked questions about the EMU
Q: How often will I see my physician during monitoring?
A: Your physician will follow your care throughout your hospital stay. Your neurologist probably will
see you every day while you are hospitalized and at regular intervals for follow-up appointments in
the clinic after you are discharged.
Q: When will I be able to drive again?
A: Do not drive a car until you have been seizure-free for three months and have been released to
drive by your doctor. You should know that the state of Texas takes this very seriously.
Q: When should I restart my seizure medication or return to normal doses?
A: Your physician will instruct you about restarting or increasing any medication doses.
Q: What accommodations are provided for my coach?
A: Each room is equipped with a sleeper sofa. Linens will be provided. We will provide in-room
dining to your coach or family member (one person). Each room has a refrigerator available, so feel
free to bring any food items you would like.
Suggested areas for patient and family parking
You will be issued one free parking pass to use during your stay to use at the parking lot in front of
ETMC Tyler. This pass can be used by you, your driver or your overnight support person. Please use
the east parking garage — the entrance is located on Lake Street off of South Beckham Avenue.
Additional visitors can purchase a week-long pass from the cashier in the parking garage at a
member/coach discounted price that allows them to come and go as they please.
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Additional information
Helpful numbers
• Main hospital. . . . . . . . . . . . . . . . . . . . . . . . . 903-597-0351
• Outpatient appointment scheduling . . . . . . . 903-531-8000
Cafeteria hours of operation
The cafeteria is located on the first floor of ETMC Tyler by the
main lobby.
Monday – Friday
Breakfast . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 a.m. – 10 a.m.
Lunch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 a.m. – 3 p.m.
Dinner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 p.m. – 8 p.m.
Deep night. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 a.m. – 3 a.m.
Saturday – Sunday
Breakfast . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 a.m. – 10 a.m.
Lunch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 a.m. – 3 p.m.
Dinner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 p.m. – 7 p.m.
Deep night. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 a.m. – 3 a.m.
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Questions and notes
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