A pilot trial of BIS monitoring for procedural sedation in the emergency department

Abstract

BIS monitoring is feasible in the ED. Our small study suggests that there is a poor correlation between BIS values and the OAAS scale. Larger studies are required to further explore this relationship. Further developments in brain monitoring technology are also needed before this form of monitoring becomes clinically useful for procedural sedation.

Procedural sedation practices in Australian Emergency Departments

“…Innovative research and critical appraisal of the literature by Australian EPs provide a local context for PSA. [10][11][12][13][14][15][16][17][18][19][20][21][22] Credentialing processes and competency-based assessments are becoming more widespread 23,24 and some Australian states have linked incentive funding to the establishment of PSA credentialing. Such processes educate staff about patient risk assessment, monitoring requirements, potential complications and the skill mix required for delivering PSA.…”

“…EPs and trainee registrars (ERs) need to acquire the required skill set through exposure to and training in decision making, anaesthetic techniques, airway and resuscitation management, orthopoedic and other procedures. Innovative research and critical appraisal of the literature by Australian EPs provide a local context for PSA 10–22 …”

Level of sedation evaluation with Cerebral State Index and A‐Line Arx in children undergoing diagnostic procedures

“…In the clinical setting, we routinely use vital signs, the ability of patients to respond to verbal or painful stimuli and titration of medications to achieve the desired level of sedation. A variety of approaches based on experience, technology and location have been described to measure depth of sedation in children (6,18,19).…”

“…A variety of approaches based on experience, technology and location have been described to measure depth of sedation in children (6,18,19).…”

Review of Bispectral Index Monitoring in the Emergency Department and Pediatric Intensive Care Unit

“…The only 2 other studies in adults have focused upon correlating BIS values with clinical sedation scores. 14,15 The largest of these studies found a moderate to good correlation with BIS values and the modified Ramsay Sedation Scale (r = À0.69, P < 0.001) and that BIS values less than 70 reliably predicted adequate sedation. 15 In pediatrics, there have been 2 studies attempting validate BIS monitoring for measuring depth of sedation.…”