What are the precautions for using Single-Use Electroencephalography BIS Sensors

1. Precautions before use

Sensor inspection

Ensure that the sensor packaging is intact, with no damage, contamination, or signs of opening. Do not use sensors with damaged packaging or expired sensors (check the production date and expiry date).

Check that the sensor electrode pads are flat and not detached, and that the conductive gel (if any) is evenly applied to the electrode contacts to avoid affecting conductivity due to gel drying or loss.

Verify that the sensor model is compatible with the monitoring device to prevent connection errors or data anomalies due to incompatible models.  

Patient Assessment and Skin Preparation  

Assess the condition of the patient's forehead skin: Do not apply electrodes to areas with skin damage, inflammation, rashes, scars, or swelling to avoid exacerbating skin damage or affecting signal quality.

If the patient's forehead has oil, sweat, hair, or dirt, thoroughly clean the area with an alcohol swab (or saline solution) and allow it to dry completely. Ensure that skin resistance is reduced (wait at least 30 seconds after cleaning until the skin is completely dry to avoid residual alcohol affecting conductivity).

For infants, elderly patients, or those with sensitive skin, confirm that they have no history of allergy to the sensor adhesive. If necessary, perform a local skin allergy test beforehand.

2. Important Notes During Operation

Accuracy of Electrode Placement

Strictly adhere to the standard positions specified in the manual for attaching the four electrodes (e.g., central forehead, above the eyebrows, temples, etc.), and avoid arbitrarily changing their positions. Otherwise, this may result in deviations in the brainwave signal acquisition area, affecting the accuracy of parameters such as the Brainwave Bifrequency Index (BIS).

Ensure that the electrode patches are firmly adhered to the skin without bubbles or wrinkles, especially ensuring that the electrode contacts are fully in contact with the skin. Gently press the edges and centre of the electrodes with your fingertips for 5–10 seconds to enhance adhesion and reduce signal interference.  

Avoid applying the electrodes too tightly or pulling on the skin to prevent patient discomfort or skin damage when removing them later (especially in children and those with sensitive skin).

Connection and device inspection

When connecting the sensor to the monitoring device, align the interface direction and insert slowly. Confirm the connection is secure after hearing a ‘click’ sound. Avoid forceful insertion or removal to prevent damage to the interface or sensor connector.

During the device self-check phase (Sensor Check), closely monitor the screen prompts: if any electrode fails the test (displaying ‘FAIL’), press the electrode again as prompted until it passes. Do not skip the self-check process, as this may result in invalid monitoring data.  

If the electrode still fails after multiple presses, check if it is improperly applied or if the skin is sufficiently clean. Replace the sensor if necessary to avoid using an unqualified electrode, which may cause data distortion.

Cable fixation and protection

After connection, the cable must be securely fixed in place. Medical tape can be used to secure the cable along the side of the patient's head or behind the ear to prevent cable pulling, twisting, or compression, which could cause electrode detachment or signal interruption.

Inform the patient and attendants to avoid touching or pulling the cable, especially when the patient is turning over or moving, to protect the cable interface and prevent accidental detachment.

3. Notes on the Monitoring Process

Signal Quality Monitoring  

Continuously observe the EEG waveforms and parameters (such as BIS values) displayed on the device screen. If signal interference occurs (e.g., irregular waveforms or significant fluctuations in values), check whether the electrodes are loose, the cables are compressed, or the patient is experiencing frequent head movements. Adjust and reposition them promptly.

Avoid using the device in strong electromagnetic environments (e.g., near large instruments, mobile phones, walkie-talkies, etc.) to prevent electromagnetic interference from affecting signal accuracy.  

Patient Safety and Comfort  

Regularly observe the patient's forehead skin during monitoring. If redness, swelling, itching, or allergic reactions occur, immediately stop use and remove the sensor. Provide local skin care as needed.

For agitated or unconscious patients, enhance supervision to prevent them from pulling on the sensor or cables, which could cause electrode dislodgement or skin injury.

Maintain a quiet monitoring environment and minimise the patient's head movements to avoid electrode displacement due to changes in body position.

4. Monitoring Completion and Disposal Precautions

Sensor Removal  

When removing the sensor, peel it off the skin slowly and gently to avoid tearing, especially for those with sensitive skin. Peel it off slowly in the direction parallel to the skin to minimise pain and skin damage.  

If adhesive residue remains on the skin, gently wipe it off with warm water or saline solution. Do not use alcohol or irritating cleaning agents to directly wipe off the adhesive residue, as this may irritate the skin.

Waste Disposal

Sensors are single-use medical devices and must be disposed of as medical waste (e.g., placed in an infectious waste bag) after use. Reuse is strictly prohibited to prevent the risk of cross-infection.

Discarded sensors must be disposed of separately and must not be mixed with general waste, in accordance with hospital infection control regulations.

Device and Environmental Cleaning

After disconnecting the device, clean the device interface (using disinfectant wipes) to prevent residual dirt from affecting future use.

If the sensor or cable is contaminated with patient bodily fluids (such as blood or sweat) during monitoring, disinfect the device surface and contaminated areas according to the disinfection procedure.

5. Special Populations and Scenarios Precautions

Special Patient Usage Requirements  

For patients with high fever, note that the sensor adhesive may become loose due to increased sweating, so frequent checks and reinforcement are required. If the patient is using an ice cap for cooling, ensure that there is no condensation in the electrode area to avoid affecting conductivity.

Pregnant women, patients with pacemakers, or other implantable electronic devices must confirm that the monitoring device and sensor do not interfere with each other electromagnetically. Consult a doctor before use if necessary.  

Contraindications  

Do not use if allergic to the sensor adhesive or conductive gel components.  

Do not use if the forehead skin is severely damaged, burned, or unable to cooperate with skin cleaning.  

Do not use in strong magnetic field environments such as MRI or CT scans to avoid sensor damage or safety risks caused by magnetic fields.

6. Other important precautions

Operators must undergo professional training and be familiar with the use of the equipment and sensors to avoid data errors or patient discomfort due to improper operation.

If abnormal data occurs during monitoring (such as persistent abnormal BIS values or signal loss), first check the sensor connection, adhesive position, and skin condition before adjusting the equipment parameters.

Record any abnormalities during use (such as skin reactions or signal problems) for easy traceability and improvement of operations.

By strictly adhering to the above precautions, the safe and effective use of single-use EEG sensors can be ensured, monitoring accuracy can be improved, and adverse events can be reduced.

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