Intro to Anesthesia p2 Flashcards
Importance of anesthetic logs (6)
- Serves as legal doc
- Set anesthetic protocol for any future events for patient
- Documents vital signs & trends intraoperatively, so problems are recognized early!
- Fill out completely and accurately
- “Tells the story” of anesthetic event
- Very important to Pt medical record
What do we monitor every 5min? (2)
- Cardiovascular: Perfusion
- HR/rhythm
- Pulse rate & quality
- MM color & CRT
- Blood pressure - Respiratory
- Rate
- Saturation
- ETCO2
What do we monitor every 15min? (2)
- Body temp
- Fluids given
What do we monitor on an anesthetic log? (8)
- Cardiovascular system
- Respiratory
- Body temp
- Fluids given
- Breathing system
- Drugs administered
- Anesthetic settings
- Anesthetic & Sx events
Tech senses
1. Sight
2. Sound
3. Smell
4. Touch
- Sight: Watch for changes in MM color, Pt movement, change in respirations.
- Sound: Listen to HR & rhythms.
- Smell: Presence of anesthetic gas
- Touch: Feel changes in pulse rates
What is this?
Pulse oximeter measures how much (%) of the available ___ is ___ with O2. The probe sensors emit wavelengths of ___ which are transmitted thru ___ and detector senses the ___.
1 & 2. Hemoglobin is saturated
3. Light
4. Tissue
5. Light
SPO2 %
___% Good
___% Look for cause
___% Find & correct
> 95% Good
92-94% Look for cause
<92% Find & correct
Lingual sensor can be used where? (3)
- Tongue
- Ear pinna
- Toe webbing
Really any hairless region
Reflectance probe can be used where using a protective sleeve? (2)
Rectum or underside base of tail
Universal C-clamp can be used where? (2)
- Feet
- Hocks
Among other regions
Blood pressure
Systolic is during ___ contraction. Diastolic is ___ pressure during cycle. The mean is the average pressure over ___ cycle (MAP).
- Ventricular
- Lowest
- One cycle
Normal BP values
Systolic:
MAP:
Systolic: 80-140mmHg
MAP: 70-90mmHg
Name two indirect BP monitors
Doppler & Oscillometric
Doppler measures ___ only
Blood pressure
- Probe placements (3)
- Cuff % to Pt leg
- Canine __%
- Feline __%
- Metacarpal, caudal to metatarsal, or tail
- Cuff %
- Canine 40% circumference
- Feline 30% circumference
Doppler cuff sizing
Too wide:
Too narrow:
Wide: Underestimate BP
Narrow: Overestimate BP
Oscillometric measures pressure ___ under the cuff. As cuff slowly deflates & flow returns the ___ & ___ are found and the ___ is calculated.
- Oscillations
- Systolic
- Diastolic
- Mean, MAP
Direct BP requires ___ catheter & is indicated for ___ patients. It gives ___ time readings. Can be very hands off and ___ ___ for the patient.
- Arterial
- Critical
- Real time
- Stress free
Capnometer (or Capnograph) measures and evaluates CO2 in patients ____ by measurement of ____.
- Breath
- Ventilation
Capnometer or Capnograph ranges
Safe:
Too high:
Too low:
Safe: 30-45mmHg
Too high: Hypoventilation. Pt producing too much CO2 or not expelling sufficient CO2.
Too low: Hyperventilation
Why is ventilation important? (3)
- not ventilating, not inhaling anesthetic gas, patient will wake up during Sx
- If hypoventilating, blood pH will become acidotic
- Hyperventilating, blood pH will become alkalotic
Apnea monitor
1. What does it assess?
2. No assess?
- Beeps following Pt expiration and will alarm after X amount of time without detected expiration.
- Doesn’t assess quality of breath
ECG/EKG lead placement in right lateral recumbency
Front right:
Front left:
Rear right:
Rear left:
Front right: White
Front left: Black
Rear right: Green
Rear left: Red
“Snow on grass”
“Smoke over fire”
The electrocardiogram (ECG/EKG) is used as an indicator of ___ activity in the heart
Electrical
What are four questions to ask/answer for rapid analysis of an ECG/EKG?
- Is the rate normal or abnormal?
- Is the rhythm normal or abnormal?
- If there is an abnormality, is it ventricular or supraventricular in origin?
- Is there is an abnormality, do I need to treat it?
Name these EKG readings
Name these EKG readings