Monitoring Flashcards
Give 3 reasons why we monitor patients during anaesthesia
- Preventing the patient from responding to the surgery (e.g. pain)
- To detect abnormalities before they turn into major complications
- To maintain tissue perfusion and oxygenation => improve patient outcome
What 3 undesirable changes can anaesthetic drugs cause
Cardiac depression
Respiration depression
Decreased homeostasis
What organ is severely affected by decreased tissue perfusion
Kidney
Name 4 causes of compromised blood flow
Decreased BP
Reduced HR
Haemorrhaging
Anaemia
Name 5 causes of decreased oxygen in a patient
Reduced RR
Low HR
Pulmonary disease
Equipment failure
Obese patient on its back - too much pressure of diaphragm
Which area of the brain do we not want to suppress functions of during anaesthesia
Hindbrain
Which 3 “hypos” do we want to avoid during anaesthesia
Hypotension
Hypothermia
Hypoventilation
Name 4 ways we can establish the depth of anaesthesia
Jaw tone
Eye position
Palpebral reflex
Capnography
Which drug causes eye position to be an unhelpful tool of assessing depth of anaesthesia and why
Ketamine
Increases muscle tone so eye position often doesn’t change
Name 2 methods of monitoring temperature of an animal
Rectal temperature
Oesophageal temperature probe
Give 3 ways to monitor the cardiovascular system
HR and rhythm
MM colour and CRT
Bleeding from the surgical site
Why is it good to listen to the heart whilst palpating a pulse at the same time
Can help you to detect any deficits
e.g. pulse rate is less than the HR, peripheral pulse has an irregular rhythm
What does capillary refill time allow you to assess
Peripheral perfusion and oxygenation
What do very pink/red mucous membranes suggest
Sepsis
Anaesthetic drugs
Low MAP (mean arterial pressure)
What do very pales pink/white mucous membranes suggest
Anaemia
Inadequate blood flow
Alpha 2 agonists
What is cyanosis, what does it suggest and what animal is it normal in
Bluish/purple discolouration of the MM or skin
Suggests low O2 saturation and severe hypoxia
Chow chow this is normal
Name 2 methods of monitoring blood pressure
Doppler
Oscillometer
How to choose a correctly sized cuff
The width of the cuff should be 40% of the circumference of the limb
What measurement does a doppler tell us in dogs and cats
Dogs = systolic BP
Cats = Mean arterial pressure
What does pulse oximetry tell use
Sp02 =% of haemoglobin that is saturated with oxygen (healthy patient should be >95%
Detects hypoxaemia
What are the limitations of pulse oximetry
A patient may not be hypoxaemic (pulse ox reading less < 95%) but may still be hypoxic, e.g. poor circulation.
How to assess amount of blood lost from surgical site
1ml of blood = 1g
Aside from respiratory rate, what else is important to consider when monitoring the respiratory system
Respiratory rhythm and effort
What does capnography allow us to assess in regards to respiratory system monitoring
Measures inhaled and exhaled CO2
What 3 things does capnography tell us about the patient
Tissue metabolism
Perfusion
Ventilation
What is the normal ETCO2 range for dogs and cats
Dogs = 35-40 mmHg
Cats = 28-45 mmHg
What does blood gas analysis allow us to measure
PaCO2 (partial pressure of carbon dioxide in the blood)
PaO2 (partial pressure of oxygen in the blood)
Blood pH
Electrolytes
Lactate
How many % of damage does a kidney have to sustain for it to show on blood work
65-70% damage
