Module 2D: monitors Flashcards
What are the 3 categories of monitoring in anaesthesia
Monitors of the machine and equipment
Monitors of patient
Clinical exam
What are machine monitors
gas supply pressures
02 concentration
breathing circuit pressure
batter and power supply
ventilator monitors
What is included in standard patient monitoring?
All patients regardless of local or general anaestehsia:
- ECG
- Pulse oximetry
- Non-invasive blood pressure
What patient monitoring must be added under general and not local anaesthesia
capnography (end-tidal CO2)
Temp (oral/nasal probe)
FiO2
How many leads are usually put on in ECG
3 leads
if very ill/cardiac patients->5lead
What info can be gathered from ECG:
HR
HR
ST segment analysis
Arrythmia alarms
What should normal pulse oximetry be?
92-100% (usually non-invasive over fingertips)
What gas analysis are included in modern machines
Capnography
FIO2 and FeO2
Inspired + expired anaestetic gas concentrations( volatiles and N2O)
What is capnography
non-invasive procedure that measures the concentration of carbon dioxide (CO2) in the airway during breathing. measured in kPa and calculates respiratory rate, between 4.5-6.0
How is capnography an essential monitor
shows that gas exchange is taking place
Shows alveoli are perfused and ventilated
What can be detected on capnography
accumulation of CO2 in circuit/exhaustion of soda lime
Oesophageal intubation (no steady CO2)
Pulmonary embolism (sudden loss of CO2)
Malignant hyperthermia (sudden rapid severe rise)
Patient breathing spontaneously against ventilator
Where are arterial lines usually placed?
peripheral artery usually radial artery
What does arterial lines help with
continuous beat-to- beat accurate BP
Continous blood sampling
Where are central venous lines inserted?
vena cava via internal jugular, subclavian or femoral veins
Give characteristics of central venous lines
may have multiple lumens
sterile procedure
used for adminitering potent/dangerous drugs like:
- potassium, inotropes, vasodilators or IV nutrition
