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• CSI is higher than expected
Check anesthetic delivery systems: IV lines and status of vaporizers.
Some patients require a higher dose of drugs due to interpatient variability.
Adequate dosing for maintenance may not be sufficient for increased stimulation.
• CSI rises along with EMG
High levels of facial muscular or electromyographic (EMG) activity can elevate the CSI
under certain circumstances. When this happens, attention must be paid to the stimuli
received by the patient during surgery. When the patient is asleep, EMG activity can
increase due to reflex reactions to painful stimuli during surgery, lack of muscular
relaxation or muscular rigidity caused by some opioids (analgesics). In the presence of
hypnotically unrelated EMG, administration of a neuromuscular blocking agent may cause
the CSI to decrease.
Note:
Facial muscles will recover sooner than skeletal muscles.
When these artifacts are present, the CSI should be interpreted with caution.
• Communication
POWER indicator on CSM Link does not turn on when power is connected
Check power connection.
Replace power cable or try alternate outlet. If POWER indicator is still not on, send CSM
Link for service
LINK indicator on CSM Link Does not turn on
Check that this actual CSM Link is chosen on the CSM.
If CSM cannot find the CSM Link:
Relocate CSM Link to obtain better signal quality.
Turn on RF communication in the CSM.
CSM and CSM Link are connected but no data appears on recording terminal
Check that the RS-232 or USB cable is connected.
Check that the recording terminal has the right setup.
Cerebral State Monitor - CSM DFU
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