GE CARESCAPE, User Manual

Page: 358 / 548

Entropy
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Entropy is not a parameter for monitoring neuromuscular blockade. Though
RE may give an indication of the patient’s reaction to external stimuli, such as
intubation and skin incision, the level of neuromuscular blockade should be
assessed with NMT, which is an active assessment of the effects of neuromuscular
blockade agents on the neuromuscular junction.
●
Neuromuscular blocking agents (NMBA) administered in surgically appropriate
doses are not known to affect the EEG, but are known to have an effect on the
EMG. RE values may drop in response to NMBA administration, due to paralysis
of facial muscles.
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The Entropy sensors and cable are designed to be defibrillation-proof.
Entropy troubleshooting
Problem Solution
Entropy values seem unstable
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Check that the sensor is not dried out.
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Check the sensor attachment and placement.
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Check the patient status.
Entropy EEG signal is noisy
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Remove disturbing equipment from the proximity
of the Entropy module or sensor.
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Check the sensor’s contact with skin.
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Check electrodes.
Entropy EEG signal is poor
●
Check the sensor’s contact with skin.
●
Check electrodes.
Entropy EEG waveform and numbers do not
correspond
●
Check raw EEG as impedance check may cause a
temporary increase in the numeric values.
●
Check the patient’s overall status.
Entropy readings seem inconsistent with the patient
status
●
Check raw EEG for QRS or other artifact.
●
Check electrode placement.
There is a sudden drop in values. A sudden drop in values can be caused by the
following:
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Bolus administration of intravenous anesthetics.
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Increase in inhalation anesthesia level.
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Administration of other medication affecting
EEG/FEMG.
There is an unexpected increase in values. An unexpected increase in values can be caused by
the following:
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Change in infusion pump settings for intravenous
anesthetics.
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Change in vaporizer settings, or fresh-gas flow
rate.
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Volume loading with infused fluids.
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Fault in the operation of anesthetic delivery
systems.
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Impedance check.
358 CARESCAPE Modular Monitors 2062971-001