QuickStart Guide Top Takeaway Series – Neuro-Monitoring

Last month, I told you that my favorite thing about Kathi’s courses are the practical takeaways for the bedside nurse. There is always something that I gain from Synapse courses that I can take back to my unit or incorporate in my personal practice to start making a difference for my patients and their families right now. 

In this month’s Neuro-Nurturing NICU Quickstart Guide Top Takeaway Series, we’ll dig in to brain monitoring. Missed last month’s blog on neuro-assessment? You can access it HERE.

In the Quick Start Guide and video series, Kathi introduces us to the 4 Pillars of NeuroNICU care – Neuro-assessment, Neuro-monitoring, Neuro-development, and Neuro-protection. 

So let’s talk Neuro-monitoring…Here are my top three practical takeaways from the Quick Start Guide video series:



We use continuous monitoring for the heart, the lungs, but what about the brain?

Continuous monitoring of the heart and lungs have long been mainstays in the NICU, but what about the brain? Think about it….we record heart rate, respiratory rate, pulse oximetry, blood pressure…important of course, but they don’t really give us information about the brain. 

Why isn’t every NICU using brain monitoring equipment just like they use cardiopulmonary monitoring equipment?  Our brain health is integral to our quality of life, and yet many NICUs do not routinely use brain monitoring equipment, or are only using it in special populations for spot-check studies such as babies undergoing therapeutic hypothermia. 

What brain monitoring equipment are you using and what protocols do you have in place for determining which babies to monitor?




What are the types of brain monitoring equipment?

If the heart rate and respiratory rate are vital signs for the heart and lungs, what are the brain’s vitals?  Kathi breaks down the two main types or categories of brain monitoring equipment – brain perfusion/oxygenation and brain function.

What monitoring tools are available to measure brain perfusion and brain function? Near Infrared Spectroscopy or NIRS is utilized to monitor brain oxygen and perfusion. Tools such as video-EEG and amplitude-integrated EEG (aEEG) are used for continuous monitoring of brain function.

Wondering which monitoring tools are right for your unit? Check out Kathi’s keys to integrating brain monitors in to daily practice HERE.




Are there tools that help us to monitor “the whole picture”?

Kathi mentioned newer classes of monitors that measure heart rate variability and more to get a full picture of physiologic stability. One example is the Heart Rate Observation (HeRO) monitor which measures subtle variations in heart rate as early warning signs for patient deterioration from a number of conditions such as sepsis, NEC, and meningitis. 

Are you using any next generation monitors in your NICU?


Stay tuned for my next Top 3 Takeaway Series post on Neuro-Development next month!

Are you ready to get started on the all-new NeuroNICU Quick Start Guide & Video Series, click HERE.

I can’t wait to hear about your top takeaways for Pillar 2!!



Blog written by Sarah Bakke

Sarah Bakke, BSN, RNC-NIC


Sarah started her career in a level III NICU in Indiana, and has worked in both level III and IV NICUs over the course of her career.  She is currently a staff nurse in the NICU at the Nemours Alfred I. duPont Hospital for Children in Wilmington, DE, and is working towards her MSN as a Pediatric Nurse Practitioner at Drexel University.

She has led a number of neuroprotective initiatives during her time at Nemours including launching a language nutrition program, founding a multidisciplinary NeuroNICU committee, and organizing quality improvement projects.  Sarah is passionate about all things NeuroNICU.

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