Monitoring Anaesthetic & Stages Flashcards
What is Stage 1 of Anaesthesia?
Voluntary Excitement
From induction to loss of consciousness
What are the key considerations when monitoring anaesthesia?
Establish a baseline for each patient so trends can be identified.
Others:
- Patient Safety
- Record of the anaesthesia event
- Record every 5 mins
- Keep the patient alive
What are the patient effects during Stage 1 of Anaesthesia?
- Pulse increases
- Respiration increases
- Dilated pupils
- Skeletal muscle tone increased
- Vocalising
- Salivation
- Urination/defecation
What is Stage 2 of Anaesthesia?
Involuntary Excitement
From unconsciousness to rhythmic breathing
What are the patient effects during Stage 2 of Anaesthesia?
- Cranial nerve reflexes present
- Eye wide open
- Pupil dilated
- Eye rotates ventromedial
- Withdrawal reflex brisk
- Breathing irregular, becoming regular
What is Stage 3, Plane 1 of Anaesthesia?
Suitable depth for minor surgical anaesthesia
E.g. Wound suturing, removal of masses.
What is Stage 3, Plane 2 of Anaesthesia?
Adequate depth of anaesthesia for most procedures
What is Stage 3, Plane 3 of Anaesthesia?
Deep Anaesthesia
What are the patient effects during Stage 3, Plane 1 of Anaesthesia?
- Breathing regular and deep
- Limb movement absent
- Pinch reflex brisk
- Nystagmus - slows then stops by end of plane 1
- Eye - ventromedial
- Third eyelid partly across
- Slower palpebral reflex
- Brisk corneal reflex
- Slight cardiovascular depression
What are the patient effects during Stage 3, Plane 2 of Anaesthesia?
- Eye - ventromedial
- Palpebral - sluggish then stops
- Corneal persists
- Pupils constricted
- Muscles relaxed
- Pedal reflex - sluggish then lost
- Tidal volume reduced
- HR + BP slightly reduced
What are the patient effects during Stage 3, Plane 3 of Anaesthesia?
- Eyes central
- Eyelids open
- Pupil size increases
- Respiratory rate reduced
- Tidal volume reduced
- Pedal reflex lost
- HR + BP reduced
What is Stage 4 of Anaesthesia?
Overdose
What are the patient effects during Stage 4 of Anaesthesia?
- Progressive respiratory failure - diaphragm function only
- Pulse either very high or very low
- Eye central with eyelids open
- Pupils dilated
- Cornea dry (corneal reflex absent)
- MMs - cyanosis to grey
- CRT increased
How can the physiological status be monitored?
Observation and measuring physiological parameters.
How can level of consciousness be monitored?
Testing reflex responses that vary according to depth of anaesthesia.
How is Cardiovascular Function monitored and measured?
- Chest auscultation with stethoscope
- Pulse rate through peripheral pulses
- Blood pressure
- Oxygen saturation levels
Cardiovascular Monitoring
What could cause tachycardia?
LIGHT level of anaesthesia
Stress
Hyperthermia
Pain
Cardiovascular Monitoring
What could cause bradycardia?
OVERDOSE of anaesthetic
Hypothermia
Vagal nerve stimulation
Cardiovascular Monitoring
Where can peripheral pulses be found?
- Carotid (neck)
- Brachial (Inside bend of elbow)
- Radial (wrist)
- Femoral (groin)
- Popliteal (behind the knee)
- Dorsalis pedis (top of the foot)
- Posterior tibial artery (below ankle bone)
How can Respiratory Function be monitored and measured?
Observation of chest or oxygen bag
Fell chest rising
Respiratory Monitoring
What can cause apnoea?
- Obstruction of airways due to obesity, age, or facial features
- Too much pressure on airways
- Problem with equipment
- Cats getting laryngeal spasm
- Too light/deep in anaesthesia
Respiratory Monitoring
What can cause panting?
- Stress
- Hyperthermia
- Pain
- Respiratory disease
- Heart failure
- Cushing’s disease
- Hyperventilating
Temperature Monitoring
Why are anaesthetised patients prone to hypothermia?
Oxygen used with inhalation anaesthesia is cold and can contribute to heat loss.
Temperature Monitoring
What are the consequences of Hypothermia? (7)
- Bradycardia
- Hypotension through reduced vascular tone and cardiac output
- Prolonged action of injectable drugs due to reduced metabolism
- Prolonged recovery
- Increase chance of infection
- Lethargy
- Collapse
