[OkieICU_RN]

Hi all. How many of you use BIS monitoring for your sedated patients? I had never heard of it before until I went on a travel assignment.

I understand the basic concept to know how far under the patient is, etc. How well do they really work? What about the patient that has the same amount of sedation during the day and BIS is in the 90's vs at night when he's asleep and it's in the 60's?

Like I said, don't know much about them.

[sumrluvr73]

What is BIS monitoring? I am not familiar with that

[OkieICU_RN]

Like I said, I'm not that familiar with it. I know it stands for bispectral index monitoring. And I know it's a monitoring device that helps assess how deep a patient's level of sedation is, like for use with Versed or Propofol gtts. That's all I know.

What else can anyone tell me about it?

[meandragonbrett]

Okie, do some browsing in the CRNA forum, or search for BIS. BIS is made by aspect and it's been discussed quite a bit on the anesthesia board. Good luck.

[adidasgirl0699]

BIS is something fairly new on my unit. It gives a number reading from 0-100. I know the higher the number, the more awake they are. i.e. 90-100 is probably what would be reading in someone fully awake. On most of my pts, we like to keep the general BIS monitor somewhere between 45-55. I know it's a continuous EEG monitor. And sometimes when we suction the pt or move em around for turning, etc, the number goes higher.

I, myself, would like to know some more about this, as I am still pretty new to it also. Sometimes I think the BIS isn't too accurate b/c of how it can jump up or down, but generally it stays about the same during the day shift.

[LoraLou]

on my unit we would use BIS only if the patient was paralyzed and sedated. We had a scale if they were on sedation only as far as awake and calm, awake and agitated, easily arousable, etc. but if somebody is paralyzed that is not going to work, so we would slap a BIS on them to make sure they were not awake underneath the paralyzation. As far as it ranging from the 60s to 90s I'm not sure, we would occasionally experience a smaller drop or rise and would just adjust the sedation accordingly. At least on our monitors a quality indicator number would pop up alongside the bis, so if that read between 90-100 we knew our BIS was accurate, if it was low you would need to try pressing down on the pad areas where it is reading and also think about changing out the whole set, that should be changed at least every 24 hours.

Lora

[Skr/101392]

I have used the BIS monitor for several years. It has gone in and out of use in the ICU. It is mainly used in the sedated and paralyzed pt's in the ICU. It does give a small picture of EEG tracing, but is only good to show some burst suppression. It also monitors grimacing and calculates that factor into the number that is displayed. We also try to keep patients around 50 and the Dr. usually gives us this parameter. I have kept it on patients that were awake and watched it as they fall asleep. It is a useful tool, but is not an end all and can not replace EEG monitoring as it is so limited. It does work great to give you some idea how sedated a patient may be. I was in the ER with a patient that had a witnessed cardiac arrest that continued to go in and out of PEA. We had given Sucs, versed, and someother medications for intubation and to treat the patient. At one point the Dr. asked for the BIS monitor. It did initally show a 35-70. I did noticed the higher number was with CPR. Unfortunately we were unable to obtain a good rhythm with a pulse for very long and when CPR was stopped the BIS did go down to zero. One would think that the sucs would be no longer working, but unknown kidney function. I do know the company does put out education CDs on this product and I would contact Aspect and get more information.