Toward solving the sedation-assessment conundrum: bi-spectral index monitoring and sedation interruption.
The sedation-assessment conundrum is defined by two diametrically opposed goals: to maintain an appropriate level of sedation, and to obtain a comprehensive neurologic examination that most accurately reflects the patient's neurologic status. A case presentation leads to a discussion of over-sedation and under-sedation issues that impact the care of critically ill patients. This information is useful in understanding the many methods of assessing sedation and interpreting individualized patient responses to sedation. The use of bi-spectral index monitoring and periods of sedation interruption are discussed within the context of addressing the sedation-assessment conundrum.
Olson
Daiwai M
DM
The University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, NC 27599-7460, USA. dmOlsen@email.unc.edu
Graffagnino
Carmelo
C
King
Kenneth
K
Lynch
John R
JR
D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D003422:Critical Care / Q000379:methods*; D016903:Drug Monitoring / Q000379:methods* / Q000451:nursing; D004569:Electroencephalography / Q000379:methods* / Q000451:nursing; D006040:Goals; D006801:Humans; D020300:Intracranial Hemorrhages / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods / Q000451:nursing; D024802:Nurse's Role; D009730:Nursing Assessment / Q000379:methods*; D010347:Patient Care Planning / Q000458:organization & administration; D011182:Postoperative Care / Q000379:methods / Q000451:nursing; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods / Q000451:nursing; D013997:Time Factors