The bispectral index monitor: A new tool for air medical personnel

Deschamp, Clyde; Carlton, Frederick B.; Phillips, William J.; Norris, Donna M.

doi:10.1016/s1067-991x(01)70059-4

Cited by 8 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sedation is a key part of clinical care to many severely ill patients requiring retrieval, and its safe practice is paramount. Over-sedation causes prolonged recovery for patients, 5 whilst under-sedation can cause anaesthesia awareness. Overcoming the environmental factors that impact sedation may not always be entirely possible but using further aids in the hope of improving the standard of practice is achievable.…”

Section: Resultsmentioning

confidence: 99%

“…8 20, 12 It has been extensively tested across a wide range of patient populations and has been shown to be effective in reducing both over and under sedation, and especially effective at reducing the risk of anaesthesia awareness. 5 One such study showed a decrease in the risk of anaesthesia awareness of 82% with use of the BIS machine, 12 with many others showing similar benefits, especially in the setting of TIVA. In fact, the NICE guidelines in 2012 stated that these monitors are recommended during anaesthesia in high risk patients.…”

Section: Challenges Of Sedationmentioning

confidence: 96%

“…17 However, some of the current clinical indicators used to measure sedation, such as blood pressure and heart rate, have been shown to be subjective and unreliable. 8,5,7,12 This has lead to the use of clinical sedation assessment scores, which are widely used to better assess a patient's current level of sedation and aid clinicians to maintain optimal sedation.…”

Section: Challenges Of Sedationmentioning

confidence: 99%

“…When delivering sedation in any environment it is important to consider the risks to patients, especially in situations outside hospitals such as in the flight environment. 5 Despite its importance and regular use, research into sedation and its risks in aeromedical retrieval is scarce. 4 However it is known that adequate sedation is important, as both over and under sedation can lead to poorer outcomes for ABOUT THE AUTHOR Matthew Stewart was a student scholarship winner for the 2016 ASAM Annual Scientific Meeting.…”

Section: Introductionmentioning

confidence: 99%

“…9 Patients in the aeromedical environment are likely to be at a higher risk of sub-optimal sedation and anaesthesia awareness than patients in hospitals. 5,11 This is because they often carry, or are exposed to, the factors shown in table 1, that increase the likelihood that they will experience anaesthesia awareness. 12 They are often more severely ill than the average surgical patient, less often haemodynamically stable and, due to the nature of the aeromedical environment, are more likely to receive only intravenous anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Sedation in Medical Retrieval – Challenges and Future Practice

Stewart¹

2018

Journal of the Australasian Society of Aerospace Medicine

View full text Add to dashboard Cite

Anaesthetic Awareness is the recall of events that occur during sedation and is a serious complication thought to occur in 0.1 to 0.2 % of the general surgical population. Sedation is an important tool used in medical retrieval, however its use in the aerospace environment is unique in its challenges for clinicians. Many of the patients carry risk factors for anaesthetic awareness and the mode of anaesthesia appropriate for the aerospace environment, total intravenous anaesthesia, also carries a higher risk compared to other methods. In addition the aerospace environment has other challenges not specific to sedation including noise distractions and the physiological effects of high altitude on patients which can impact on the ability to provide adequate sedation. Given all this, patients receiving sedation during medical retrieval would seem to be at a higher risk of anaesthetic awareness than many of their counterparts on the ground. For many high risk patients in hospitals technology such as brain monitoring has been shown to be effective in reducing awareness. Therefore as patients in the air are as likely, if not more likely to be at risk of awareness the use of this aid in medical retrieval is raised for consideration. However this technology will only ever be an adjunct to clinical expertise and an overall understanding of the flight environment and its challenges will allow for best patient care possible and the reduction of awareness during sedation.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Challenges Of Sedationmentioning

confidence: 96%