[jgeorgern4]

Is anybody using the BIS monitor on your sedated patients? A lot of our new nurses are oversedating or undersedating our patients and I wondered if the BIS would be useful. Our medicine patients can be intubated for weeks, then when we try to wake them up it can take a while. Seems like some folks like it and others don't.
We did a trial in our unit but I never saw the results and the unit went away.
Thanks, James

[nurse-lou]

We trialed the BIS monitor in our unit a few years ago. I for one LOVED it! It didn't get approved because of the cost of the unit and that each probe costs $17 each!

Sedation is a fine line. You could give the same dose of ativan to two different pt's and it would affect each one differently. I bring this up to my manager all the time. Seems the Intensivists thought that I oversedated my pt once. Well, when a pt on the vent is rattling the side rails and biting the ETT, that calls for some sedation to me. I had to give him something every hour to keep him from getting agitated and bucking the vent. But I digress.

I would LOVE to see the BIS monitor brought back to our unit. But again , the powers that be probably won't because of the cost. I think they could really help keep a pt sedated at the right level. Especially with new nurses. Good luck!

[marissa81579]

Where I worked, we used it on patients who were (pharmacologically) paralyzed. I think it is one tool that should be used in conjunction with the entire assessment. I would fear a new nurse would rely on it too much.

[SDNavyRN]

Anesthesia has brought it upstairs a few times on VIP pts when the MICU team has requested it....I didnt like it at all, the number it would give for sedation levels would not at all correlate with patient assessment...to be fair, nursing did not receive a proper inservice, it was like we just walked in one day and someone had smacked it on our pt overnight, but the majority of us ended up ignoring the thing altogether and going by our sedation score like always....

[PJMommy]

BIS is useful when patients are also neuromuscularly paralyzed and you have absolutely no other means of assessing the level of sedation. However, you cannot rely on the BIS for sedation. In fact, trials and research have inconclusive results as to its effectiveness. We use RASS scores to assess sedation - these demand a little clinical assessment skill.

One other comment, as another thread on this board is mentioning, too many nurses and most doctors fail to realize that you can't appropriately sedate a pt who is writhing in pain. I've seen the pt on 100 mcg Propofol bucking the vent and squirming all over - same pt with a Morphine gtt will only use 50 mcg Propofol and be happily chilled.