Calculates the surface EEG data into numerical form. 

It is a complex means of calculating EEG data.

(Basically the nano-men in the brain- communicate with the nano-men that live in the little forehead sticker.  The nano-men in the forehead yell, "hey we could use some more  drugs down here."  And the nano-men in the sticker say, "Well how much do ya need?"  Then the nano-men in the forehead shout back whatever number they seem to be jonesing for, like- 52 nanoliters per nanomol.  Then the nanomen punch some keys in a little nano computer and make "52" show up on our monitor.  Then we can decide if 52 is a number that would cause us to potentiate nano-men narcotic addiction.  Well that's the way I see it anyway. Of course narcotics don't change the BIS so I guess that blows my theory out of the water.)

1) Small amplitude (microvolts)

2) Variable frequency

What happens with the EEG when patients are given most sedative hypnotics/general anesthetics? 

What drug might be an exception?

1) Sedative hypnotics/general anesthetics:

- Slow down the Frequency of EEG

-Increase the amplitude of EEG

2) Ketamine is an exception to this rule.

Answer true or false to the following statements:

1) The BIS monitor cannot replace good judgement

2) Data provided by the BIS does not help in providing a balanced anesthetic

3) The BIS provides data that can determine depth of anesthesia

4) The data consistenty shows a 35% reduction in anesthetics used.

5) Using the BIS can aid in shorter emergence times.

6) There is no correlation between improved post operative outcomes (shorter hospital stays, improved PONV etc.) and utilizing the BIS monitor.

7) Currently the BIS monitor is being used exclusively operating rooms.

1) True

2) False:  Data provided by the BIS can aid in decision making in providing a balanced anesthetic

3) True

4) False:  The data consistently show a 25% reduction in anesthetics used (not 35%)

5) True

6)  False:  There is a correlation between using the BIS and better pt. outcomes.

7) False:  The BIS is now being used in arenas other than just the OR to control the depth of sedation.  (As a matter of fact I am wearing one right now)

1)  What numerical range does the BIS give you?

2) At what value is the pt clinically awake?

3) At what value does the incidence of explicit recall decrease dramatically?

4) What happens at values less than 60?

5) How about less than 40? 

6) Which clinical values correlate with a better recovery in both the OR and post operative period?

1) 0 to 100

2) 100

3) 70

4) The patient has a very low probability of recall or conciousness

5) Pt. enters a deep hypnotic state. 

6) 40-60

1) What is burst suppression?

2) What does it indicate?

3) At what BIS values does this occur?

4) What types of things cause burst suppression?

5) What does a BIS value of 0 indicate?

1) Burst suppression is low frequency, high amplitude EEG waves that are considered an abnormality.

2) indicates encephalopathy

3) Values less than 20

4) Causes: Brain Trauma, stroke, anoxia, hypothermia, seen in infants,  or induced by anesthetic drugs. 

5) Flat line EEG

What kind of prep should I do to make sure the BIS monitor works at optimum level?

1) Good skin prep.

- clean the forehead of oil (alcohol swabs are often used) 

2) proper placement of BIS strip

(read directions) 

3) Press and hold BIS strip for awhile to ensure great adhesion.

Fill in the Blanks Bitches: 

Signal quality index (SQI) quantifies the ___(1)____ of the signal.  A value less than ____(2)___ is indicative of a poor signal.  The __(3)_____ the value, the better the signal.   If the SQI is graphed, the graph consists of bars divided into increments of _____(4)_____.   Other monitors may read out a _____(5)____ value.  A score or bar depiction of _____(6)____ would be the optimal number indicating a _____(7)_____ signal.

1) quality

2) 50%

3) Higher

4) 10

5) Numeric

6) 100

7) Strong

1) With the BIS monitor, what number or bar indicates the amount of artifact or interference?

2) What are some things that produce artifact?

3) What is the most common producer of artifact in the BIS

1) The EMG (electromyelogram) number

2) -Electrocautery

-Pacemakers

-fluid warmers

-Air blankets

-surgical drills

-Patrick Exuding Fantasticisms

3) EMG is the most common producer of artifact in the BIS.  The BIS lies over the forehead muscles- tightening of the frontalis muscle (as with lighter anesthesia w/o muscle relaxants on board)  cna produce an elevated BIS number.

Fill in the Blanks regarding the BIS part deux:

The ___1____ ratio indicates the percentage of time (over the previous 63 seconds) that the ____2____ was in an isoelectric state.  A value of _____3_____ would mean that the pt. was isoelectric for the entire previous 63 seconds.  A value of ______4______ would indicate the patient was never isoelectric.

1) supression

2) EEG

3) 100

4) 0