3. Monitors in Anesthesia Flashcards
Monitoring
Patient must be ____ at all times
A ____ record must be kept
All patients must have a ____ and physical and baseline vitals
watched
comprehensive
history
Monitoring: Parameters
____ Ventilation ____ Temperature
oxygenation
circulation
Monitors: Desirable Properties
should be easy to ____
should be ____ (nasal cannula is NOT comfortable)
should be ____
should provide information ____
use
comfortable
reliable
rapidly
Monitors:
____ or automated
____ and/or visual alarms
____ devices
____ or noninvasive
most we use is ____
____ more important because we can’t constantly look
manual
audible
recording
invasive
noninvasive
audible
Standards for Basic Anesthetic Monitoring
Established in October 1986 by the American Society of Anesthesiologists
Require adherence to ____ levels of monitoring
Revised ____
minimal
revised
Standards for Basic Anesthetic Monitoring
Standard I:
Qualified anesthesia personnel shall be ____ in the room throughout the conduct
of all general anesthetics, regional anesthetics, and monitored anesthesia care.
Standard II:
During all anesthetics, the patient’s ____, ventilation, ____, and temperature shall be continually evaluated.
present
oxygenation
circulation
Mortality rates
Range from 7.9 per 10,000 to 1 per 400,000 anesthetic cases
65 to 87% of them is due to ____ error
The most common problem is failure to ____ a patient
human
ventilate
Goals of Monitoring
Aids in the ____ of anesthesia administration
Improves patient outcome by allowing ____
recognition of potentially life complications
efficiency
early
Monitors
Pulse Oximeter
Introduced into 1983
Based on the relative difference in which ____ and ____ blood transmit and absorb ____
Oxygenated blood - ____ nm
Dexoygenated blood - ____ nm
-
The percentage of oxygenated hemoglobin can be ____
oxygenated deoxygenated light 660 940 obtained
Oxygen-hb dissociation curve
We get percentage of oxygenation saturation of our hemoglobin from this oximeter. This is a ____ monitor and will give information quickly. Most importantly, it gives ____ in ____ blood. Without oximeter we would need to draw blood from patient’s arterial line to find out partial pressure of oxygen or carbon dioxide and blood pH level. This would take a while to do after sending to lab so the pulse oximeter does this right away.
A normal O2 saturation would be ____%. Once you start dipping to 90%, it is really telling you that the partial pressure of oxygen is only ____. Normal is ____. 80 in old, ____ in younger people. Curve starts to drop at ____% saturation.
non-invasive partial pressure of oxygen arterial 98-100 60 80-100 100 90
Pulse oximeters:
errors
Accuracy varies from unit to unit \_\_\_\_% failure rate \_\_\_\_ light reaching sensor Peripheral \_\_\_\_ - if blood isn't getting there readily you won't get a good read. \_\_\_\_ artifact \_\_\_\_ polish
because infrared needs to be read through nail bed. can use toe nail if this is the case haha
2.5 to 7.2 ambient vasoconstriction motion nail
Monitors: ventilation \_\_\_\_assessment \_\_\_\_ stethoscope \_\_\_\_
____ is the most important of the 4 parameters to monitor
visual and auditory
precordial
capnograph
ventilation
Precordial stethoscope
A weighted stethoscope head is secured with ____ to chest or neck
tape
Capnograph
Measures ____ (ETCo2)
Analyzes the concentration of carbon dioxide during ____
end-tidal carbon dioxide
exhalation
ETCO2 vs PaCO2
PaCO2 is the concentration of carbon dioxide in the ____ blood.
ETCO2 is the concentration of carbon dioxide in the ____ gases.
The gradient between these is less than ____ mm Hg
arterial
exhaled
5
