Bispectral index monitoring in helicopter emergency medical services patients

William G Heegaard, Ryan Charles Fringer, Ralph Frascone, Greg Pippert, James R Miner

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background. Many critically ill patients are given sedatives andparalytics to facilitate aeromedical transport. Bispectral index (BIS) monitoring is a computer-derived electroencephalography (EEG) analog currently used to monitor the level of awareness of sedated patients. It gives a score of 1100, with 1 representing no brain function and100 representing a completely alert patient. Objective. To evaluate whether critically ill patients are adequately sedated during aeromedical transport. Methods. This was a prospective, observational study of a convenience sample of critically ill patients transported by helicopter. All intubated patients who received sedatives and/or paralytics to facilitate transport were eligible for enrollment by the attending clinician. Prior to liftoff, a BIS sensor was applied to the patient's forehead. Minimum, maximum, andmean BIS index scores were recorded every minute during transport. Results. Forty-seven patients (57 male) were enrolled, with a median age of 60 years (interquartile range [IQR] 1881, range 14 to 86 years). The median duration of monitoring was 15.0 minutes (IQR 6.026.0, range 2 to 33). The median BIS score was 54.6 (IQR 38.667.3, range 28 to 89.5). Only two patients (4.3, 95 confidence interval [CI] 0.5 to 14.8) had at least one BIS score greater than 85, the accepted threshold for recall. Conclusion. These results suggest that patients are adequately sedated during air medical transport.

Original languageEnglish (US)
Pages (from-to)193-197
Number of pages5
JournalPrehospital Emergency Care
Issue number2
StatePublished - Jan 1 2009


  • Air ambulance
  • BIS monitor
  • Conscious sedation
  • Sedation in HEMS

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