Seizure disorders Long term monitoring LTM (1732)

Your child is scheduled for a Long Term Monitoring (LTM) in the Epilepsy Monitoring Unit (EMU) of Children’s Wisconsin. When you arrive, please stop at a Welcome desk for a badge and directions to Admitting. 
• Your child will be in the hospital for at least 2 (or more) days.  Please plan for this.
• Be at the hospital 10 minutes before your appointment time. If you come earlier, you will be given a pager. The pager will go off when your child’s room is ready.
• When you are done in admitting, you will be brought to the EMU. 
• If you have questions about insurance, contact your insurance company.

Please call (414) 266-6828 if you have questions after reading this sheet or: 
• If your child has a cold, the flu, or a fever, if your child is ill, the admission may be rescheduled.
• If your child has autism or any sensory issues.

This information will help you and your child know what LTM is and what to expect. 

A parent or legal guardian must be present for your child to be admitted. If you are the legal guardian, please be sure we have the legal documents that confirm your status. If a parent or guardian cannot be present, the LTM will be rescheduled.

What is LTM?

• LTM uses continuous EEG to see how your child’s brain works during a seizure. A video camera and microphone will also be used to record during the LTM.
• The EMU doctor will look at the data. This doctor will decide if a seizure happened and what the best treatment will be.

Does it hurt?

No. Your child will feel no pain during the recording. The EEG electrodes often itch. It may be uncomfortable for your child to sit still while the EEG electrodes are being placed. It takes about 90 minutes to do the LTM set-up.

How do I prepare for the LTM?

• Wash your child’s hair the night before the LTM admission. Use shampoo only.
• Do not put anything else such as cream rinse, conditioner, oil, mousse or hairspray on your child’s hair or scalp.
• Hair must not have braids, extensions, weaves or hairpieces. If our staff are unable to easily get to your child’s scalp the LTM may need to be rescheduled.

Who will we see during the stay?

• A nurse will ask questions about your child’s medical history and check your child’s blood pressure, height, and weight.
• EEG technologists will attach the EEG leads to your child’s scalp. They may also need to move or fix the leads to assure a good EEG recording and to prevent skin breakdown on your child’s head.
• An Advanced Practice Provider (APP) will do a physical exam and get your child’s medical history. An APP is either a pediatric nurse practitioner (PNP) or physician assistant (PA). The APP manages the daily medical care. This includes all medicines, safety precautions and routine care. The APP works along with the EMU epileptologist.
• The EMU doctor will review the results of the LTM with the APP each day. Your child’s neurologist will also have access to the results.
• Your child may need to see other doctors and other health care providers while in the hospital.

What should I bring to the hospital?

Your child will not be able to leave the room while being monitored. Bring plenty of things for them to do, like:

• Games
• Favorite blanket or stuffed animal.
• Video’s or DVD’s
• Books
• Playing cards
• Schoolwork

It will be helpful to bring button-up shirts for your child. Do not forget to bring their personal items like glasses or hearing aids.

Also bring any items for you may need, such as:

• Personal care items, such as soap, shampoo, and deodorant.
• Food for yourself.
• Money if you plan to buy meals for yourself.

Please leave valuables, such as jewelry, at home.

How long will my child be monitored?

• It is hard to know for sure how long your child will need to stay in the hospital. Your child will spend at least one night (or more) in the EMU. It may take a few days before a seizure occurs.
• The APP will talk to you about how long you will be in the EMU. Your child’s neurologist will be involved in any decisions about the treatment plan. 

Safety Information for LTM

Your child is having LTM to evaluate seizures. These safety tips will help prevent injury if your child has a seizure.

• A parent or guardian must be with your child at all times during LTM.
• Your child must wear a helmet at all times, unless they’re in bed.
• Your child will have an IV placed shortly after arriving to the EMU. This is to let us give your child medicines quickly if a seizure occurs.

What will happen when my child is in the hospital?

• Your child will be asked to change into a hospital gown or button-up shirt.
• Your child will have blood tests drawn while in the hospital (this involves drawing blood from a vein in the arm).
• You will asked to push a button every time your child has an event. This helps the EMU doctor know how the EEG matches the events that are seen at home or school.

Will someone need to stay with my child?

Yes. A parent or guardian must be with their child at all times during LTM. If a parent or guardian cannot be present for the whole time your child is in, the LTM must be rescheduled.

• When possible, the nurses will help give 2 to 3 short 10 to 15 minute breaks during the day. If longer breaks or breaks more often are needed, you will need to have an adult over 18 years that knows your child’s seizures stay with your child.
• A small bed is available in your child’s room for parents or guardians. Two parents may stay overnight in the room during the hospitalization.
• Brothers and sisters may visit, but are not allowed to stay overnight.

What can my child do during the monitoring?

• Have friends and family visit during regular visiting hours.
• Watch movies and videos. There is a VCR/DVD player available.
• Use the bathroom.
• Watch TV or listen to the radio. Cell phones and laptops may only be used by your child in battery mode. Parents may use a cell phone or laptop that is plugged into a wall socket only when they are not near their child.
• Take turns with other children going to the playroom. Only one child on LTM may be in the playroom at a time.

What can’t my child do?

• Be alone at any time in the EMU.
• Leave the EMU.
• Play with any sharp toys or objects.
• Chew gum.
• Take a shower or bath. A sponge bath is OK.
• Do anything that could cause harm such as jumping on the bed.

***Please note: A parent/guardian may not sleep with the child at any time during the LTM admission. This could keep staff from clearly seeing your child during the seizure.

What about my child’s medicines?

• Before you come to the hospital, give your child their medicine at the normal time. If your provider gave you different instructions, follow those instead.
• We must verify all of your child’s medicines. You must bring a list of all of your child’s medicines. List the names, doses, and how often you give them. If you prefer, take a picture of the labels or bring the medicines with you.
• We will provide your child’s medicine while they are staying here. The medicines you bring will only be used if we do not have them in our pharmacy. You will be responsible for the safety of the medicine that you bring with you to the hospital.
• If your child takes any medicine that needs to be kept in a refrigerator, please leave it at home. If you need to know if the hospital carries it, contact your child’s nurse or provider.
• When your child is in the EMU, the medicines your child has been taking may be reduced or stopped. We do this to increase the chances of capturing an event during the LTM.
• Your child’s neurologist will let you know if changes are needed in your child’s medicine after the LTM.