Brain function sedation monitors.

GmanRN · Sep 1, 2007

Youre referring to a BIS monitor. They can tell you the level of a patient's sedation. This can be very helpful when using paralytics. Just because a patient is paralyzed doesnt mean they are sedated. They could be very aware of their surroundings. If they are in surgery, well im sure you can imagine the problem there.

ICU nurses use them with propofol to keep the level of sedation moderate. A reading of 20 is comatose. 50 would be considered moderately sedated. Of course a 50 in one patient doesnt necessarily have the same effect as a 50 in another. It still can be a useful measurment in quanitfying the level of sedation.

Im not sure what the CRNAs like to keep the BIS at during surgery. I hope to find out one day as Im aspiring to become one. Maybe someone could elaborate.

G

Electric · Sep 2, 2007

Typically you keep the BIS score at 60 or below for general anesthesia.

allnurses Guide · Sep 2, 2007

Are these a standard piece of equipment used during surgeries or is it a preference thing? Do they help all that much?

The BIS monitoring system is still very controversial in anesthesia. From all accounts it is not as reliable as it needs to be, yet. http://en.wikipedia.org/wiki/Bispectral_index

kessadawn, BSN, RN · Sep 2, 2007

ICU nurses use them with propofol to keep the level of sedation moderate. A reading of 20 is comatose. 50 would be considered moderately sedated. Of course a 50 in one patient doesnt necessarily have the same effect as a 50 in another. It still can be a useful measurment in quanitfying the level of sedation.

G

We use the BIS occasionally in our PICU. I'm not really sold on it. If your pt has a problem in brain function as their baseline (sz d/o, TBI, etc) the readings on the BIS are not going to be accurate. You have to really know your pt, know what the monitor reads when they are sedated, and adjust your sedation needs from there. I've seen awake kids reading 30 and snowed kids reading 75. Also, the lead strip doesn't stick well on sweaty pts.

Just my :twocents:

Burnt2 · Sep 2, 2007

I think they kind of suck and are more or less inaccurate. In our unit they're viewed as a piece of PR equipment to impress families with our technological up-to-dateness.

I've had them on several patients and what the monitor says hasn't ever really correlated clinically (this is all anecdotal from my personal experience)

One shift a nurse on our unit just used the bis to titrate sedation (ativan/fentanyl drips) and the guy lost his gag/didn't come around for 3 days. But hey, the BIS reading was 55-62.

Electric · Sep 4, 2007

The BIS monitoring system is still very controversial in anesthesia. From all accounts it is not as reliable as it needs to be, yet. http://en.wikipedia.org/wiki/Bispectral_index

Please use medical references.

Wikipedia is not a medical reference.

allnurses Guide · Sep 5, 2007

Please use medical references.
Wikipedia is not a medical reference.

No Kidding!!! But I am not going to spend my time looking up sources on cinahl/ovid and quoting them for people who for the most part won't have access to them. The information was consistent with what I have been taught, and I felt it was unbiased. So, in all those regards it is a good reference for general information none the less.

Here is the link provided in wikipedia.http://www.anesthesia-analgesia.org/cgi/content/full/100/4/1221

allnurses Guide · Sep 6, 2007

Look at the information provided on wikpedia. The author provides a link to his information.http://www.anesthesia-analgesia.org/cgi/content/full/100/4/1221

dfk, RN, CRNA · Sep 7, 2007

Youre referring to a BIS monitor. They can tell you the level of a patient's sedation. This can be very helpful when using paralytics. Just because a patient is paralyzed doesnt mean they are sedated. They could be very aware of their surroundings. If they are in surgery, well im sure you can imagine the problem there.
ICU nurses use them with propofol to keep the level of sedation moderate. A reading of 20 is comatose. 50 would be considered moderately sedated. Of course a 50 in one patient doesnt necessarily have the same effect as a 50 in another. It still can be a useful measurment in quanitfying the level of sedation.
Im not sure what the CRNAs like to keep the BIS at during surgery. I hope to find out one day as Im aspiring to become one. Maybe someone could elaborate.
G

BIS is currently being used in the OR to help guide the level of amnesia during surgery. has nothing to do with paralysis. that's what a nerve stimulator (and clinical picture) is for.

ideal level is roughly 40-60 for general anesthesia.