18 Monitoring BIS
BIS Safety Information
For information on the use of BIS in specific monitoring situations and on pharmacological responses
to the anesthetic agents Nitrous Oxide (when used as the sole anesthetic agent), Ketamine, and
Etomidate, please contact Aspect Medical Systems to request a copy of their publication "A Clinician's
Guide to the Bispectral Index®".
Considerations for Use
Due to limited clinical experience in the following applications, BIS values should be interpreted
cautiously in patients with known neurological disorders, those taking psychoactive medications, and
in children below the age of 1.
Conductive Parts: The conductive parts of sensors and connectors should not contact other
conductive parts, including earth.
High-frequency Surgery: To reduce the hazard of burns in the high-frequency surgical neutral
electrode connection, the BIS sensor should not be located between the surgical site and the electro-
surgical unit return electrode.
Defibrillation: The BIS sensor must not be located between defibrillator pads when a defibrillator is
used on a patient connected to the patient monitor.
Securing Cables: To minimize the risk of patient strangulation, the patient interface cable (PIC) must
be carefully placed and secured.
Revisions: The system will only function if all component revisions are compatible. Otherwise, an
incompatibility INOP is displayed.
If the DSC has an older software revision than the BIS Engine, the DSC will automatically be
upgraded by the BIS Engine. Do not disconnect the DSC from the BIS Engine, or disconnect the BIS
module from the monitor, or switch the monitor power off within the first ten seconds after
connection, as this will disrupt a possible software upgrade and cause damage to the DSC.
Impedance Checks: Impedance checks may influence data acquisition of other