Risk of choking and aspiration during inpatient video-EEG monitoring

Seizures can cause airway compromise and aspiration. This is a potential concern during inpatient video-EEG monitoring (vEEG), where seizures are provoked for diagnostic purposes. The frequency of aspiration and efficacy of nursing interventions to protect the airway were evaluated in this retrospective study of 590 partial complex (PC) and generalized tonic clonic (GTC) seizures recording during vEEG. 33 seizures (5.6%) occurred while patients were eating or drinking, 14 with food in the mouth at onset. 4 (0.6%) were followed by post-ictal emesis. Supplemental oxygen was provided in 93% of GTC seizures, and oral suctioning in 85%. Lateral decubitus positioning was used in 53%. These interventions were applied in a minority of PC seizures. There were no choking events, one suspected aspiration without subsequent complication, and no aspiration pneumonia. It is uncertain if interventions such as oral suctioning, lateral decubitus positioning, or oxygen administration reduce the risk of aspiration during vEEG.