Prepare for the EMU
What is the Epilepsy Monitoring Unit (EMU)?
What Kinds of Patients Are Admitted to the EMU?
What Is the Procedure for Admission Into the EMU?
What Can Patients Expect While in the EMU?
What Is the Average Length of Stay in the EMU?
Who Takes Care of Patients in the EMU?
What Can Patients Bring With Them During Their Stay?
When Are Visiting Hours?
Special Diets in the EMU?
Ketogenic Diet and Low Carb diets in the EMU?
For the Family of Out-of-Town Patients...
Billing
Preparation for Surgery
What is the Epilepsy Monitoring Unit (EMU)? The EMU is a specialized six-bed inpatient unit at The Johns Hopkins Hospital designed to evaluate, diagnose and treat seizure patients of all ages. Staffed with specially trained medical, nursing and technical personnel who monitor patients 24 hours a day, the EMU is equipped with computer-based monitoring equipment expressly designed for the evaluation of seizure disorders. Based on this evaluation, treatment options can be determined.
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What Kinds of Patients Are Admitted to the EMU? Patients who suffer from seizures that are difficult to diagnose and to manage are those most likely to be admitted to the EMU. Patients who are being considered for seizure surgery and need to be monitored to locate where in the brain the seizures begin will also be considered.
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What Is the Procedure for Admission Into the EMU? Patients will have an initial consultation at the Johns Hopkins Outpatient Center with a physician from the Epilepsy Center . An admission will then be scheduled, if appropriate.
On the day of admission, we ask that you report to the Main Admitting Office (located in the Nelson Building at the Wolfe Street Entrance) between 10:00 a.m. and 11:00 a.m. The admission process may take two hours or more. You should plan to leave by 9:00 a.m. on the day of discharge. Referring physicians will receive a full report from the patient’s EMU neurologist after discharge.
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What Can Patients Expect While in the EMU? The morning of admission, patient’s hair should be clean and free of hair products, such as hairspray, styling gel, hair grease or pomade, hair extensions or braids.
Each patient will have a private room with a private bathroom.
In the EMU, seizures are recorded and studied so that proper diagnosis can be made and treatment can begin. Patients will be connected to video and computerized EEG monitoring equipment 24 hours a day. Although the lack of privacy is bothersome to many patients, continuous monitoring is necessary to help safeguard patients and gather the needed information.
Patients will have an I.V. placed in their arm to allow for emergency medications to be given if necessary.
Patients who take medication to control seizures may have their dosage adjusted or discontinued so that seizures can occur and be recorded and analyzed. This procedure will be discussed with each patient before any changes are made. Patients who feel particularly anxious about this are encouraged to speak with their doctor and nurse.
Because the EEG wires are connected to recording equipment, mobility is restricted and patients should expect to spend most of their time sitting in bed or in a nearby chair. Because the electrodes will remain on the patient’s head, patients cannot wash their hair or shower until monitoring is completed.
Patients who experience an aura, a warning that sometimes occurs prior to a seizure, should report this to an EMU staff member. Patients or their visitors should also notify staff of each seizure they suspect as it occurs. Describing out loud what is happening as it occurs is possible since microphones are placed in each room. This taped information is important in the analysis of the event. There is also a “button” at the bedside which signals the EMU staff and the monitoring computers that a seizure is occurring. The button should be pressed as soon as a seizure begins.
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What Is the Average Length of Stay in the EMU? The length of a stay in the EMU varies with each patient, depending upon the tests and monitoring required and the number of seizures each patient experiences. On average, patients stay between three to seven days. After discharge from the EMU, some patients may remain in the hospital for one to two days to regulate blood levels and readjust to seizure medications.
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Who Takes Care of Patients in the EMU? The EMU team includes neurologists, neurosurgeons, nurse specialists, EMU technicians, psychologists, counselors, social workers, computer specialists and biomedical engineers. All are involved in the care of each EMU patient. Specially trained Meyer 8 Epilepsy nurses provide nursing care.
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What Can Patients Bring With Them During Their Stay? Patients should bring all medicines they are currently taking, including non-seizure medications. All medicines will be reviewed upon admission.
Patients in the EMU are encouraged to wear their own loose fitting street clothes with shirts that open in the front (no pullover tops) unless they have been advised otherwise. Patients should bring personal care items from home. The EMU is located on an adult floor and does not have Child Life services or a play room. Parents of young patients may find it helpful to bring special toys and/or a blanket with them to help their child feel more comfortable. Each EMU room has a VHS video and DVD player. Please feel free to bring snacks, games, books, cassette players, hand-held video games, CD players, laptop computers, DVDs, videos or crafts to help pass the time. Television service is free for pediatric patients, but a fee is charged for adult patients. Internet access is available via a phone line in each room. Patients need to make arrangements with their internet service provider for a local number for dial up service before coming to the EMU.
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When Are Visiting Hours? Visiting hours are noon until 8:00 p.m. Each patient is limited to two visitors at a time.
Family members are encouraged to spend as much time as they wish with the patient, including overnight stays for one family member. If the patient has special needs or is under the age of 18, a family member should plan on staying with the patient overnight during the length of stay. A cot will be provided.
Please call the EMU nursing coordinator at 410-955-7358 if you have questions regarding visiting privileges.
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Special Diets in the EMU? Please let the EMU nursing coordinator know if you or your child is on a special diet when scheduling an admission to the EMU. A food service (3 meals and a snack) is supplied as part of your room cost for the hospital stay. There is an alternative menu posted in your room for the hospital basic food service. If you would like alternatives (fee at point of delivery) to this service, food can be ordered and delivered from local restaurants and/or ordered from the Marburg Pavilion. Please check with your nurse when being admitted to discuss these options.
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Ketogenic Diet and Low Carb diets in the EMU? Please plan to bring several meals and snacks with you at the time of admission. We will provide a small refrigerator to help keep items cold. There is no hospital meal plan for low carb diets, so a special dietary consult will be needed at the start of your EMU stay. For the Ketogenic diet, bring your scale as you will need to weigh food during the admission. Also bring your Ketogenic reference manual and meal plans from home to assure continuity of the diet during your child’s stay.
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For the Family of Out-of-Town Patients: Information on local hotels can be obtained from the Accommodations Services Office at 800-225-2201 or 410 614-1911. Discounted parking coupons may be purchased at the Cashier’s Office located in the Main Admitting Office.
To make arrangements to stay at Maryland House or Ronald McDonald House please call your Neurologist’s office at Hopkins and their medical coordinators will help with these arrangements.
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Billing: Charges will vary according to the types of studies, procedures, services performed, and length of stay for each patient. Patients are responsible for calling their insurance companies to notify them of their admission and to verify coverage of the monitoring tests, which tend to be costly. Most health insurance plans do not cover the full amount of the hospital charges. Please keep in mind that you are responsible to pay for any uncovered hospital charges, the deductible, if required, and any out-of-pocket expenses prior to admission. You will receive a separate bill for doctor’s fees and will also be required to pay any uncovered amounts for physician services. The EMU nursing coordinator is available to help with insurance questions at 410-955-7358.
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Preparation for Surgery
Presurgical Testing: After monitoring in the EMU, the patient’s case is presented at a Tuesday seizure conference where several seizures will be viewed and the EEG will be carefully analyzed by the entire Epilepsy Team. Recommendations are then given to the referring doctor as to whether the patient is a surgical candidate and what further testing may be needed before surgery. The following tests are usually ordered after the patient’s first EMU stay. These tests may, however, be ordered at each physician’s discretion after or before a clinic appointment.
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