• An-Yi Wang, Chien-Hua Huang, Wei-Tien Chang, and Wen-Jone Chen.
• Department of Emergency Medicine, Taipei Medical University Hospital, Taipei City, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan. Electronic address: anyimilk@gmail.com.
• Am J Emerg Med. 2016 May 1; 34 (5): 934.e1-3.

AbstractBispectral index (BIS) is a simple, noninvasive, and continuous electroencephalographic monitor that could reflect the level of consciousness.Initially, BIS was developed to measure the anesthetic depth during operation; now, BIS could be used as a predictor of neurologic outcome in postresuscitative care. We report a case that had out-of cardiac arrest due to subarachnoid hemorrhage, and we used BIS to monitor the patient's consciousness level. During observation, another episode of cardiac arrest occurred due to delayed cerebral ischemia–related cardiac depression. Low bispectral index and high suppression ratio represent decreasing brain activity suggestive hypoxic ischemic encephalopathy.This was confirmed by brain perfusion scan and standard electroencephalographic study. Using BIS, we can identify patients with poor neurologic outcome earlier, and treatment could be alleviated if prognosis is futile.

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