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Aspect: What was your first experience with the BIS monitor?
ML: Our medical director, Philip S. Gibbs, MD, FCCM, staff anesthesiologist, introduced us to BIS. Aspect: What was it about this patient that led him to suspect that BIS might have some value? ML: The patient was receiving a non-physiologic form of mechanical ventilation and we were having trouble sedating him. Dr.Gibbs thought that if we could get a more accurate assessment of where we were with the patient?s level of sedation,we?d be better able to ventilate the patient. We didn?t realize then that our use of BIS would blossom to where it is now. At the time, we were just looking at the benefits for this one patient. Aspect: When did you realize BIS was going to be useful with other patients in the ICU? CF: Once we started using BIS with other sedated and paralyzed patients, we quickly realized that BIS could help us improve our clinical judgment as we guided them through sedation.We found that clinical observation alone was often inaccurate. It made sense for us to develop a clinical protocol that utilized BIS technology on paralyzed sedated patients because we could not objectively assess their level of consciousness or their risk for experiencing recall. When we realized how BIS helped us in this situation, its usage spread like wildfire.
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