monitoring during anaesthesia - anaesthetics

Question 1

monitoring during anaesthesia

Answer 1

• clinical observations
• Respiratory monitoring
• Cardiovascular monitoring
• Neurological monitoring
• Thermoregulation monitoring

Question 2

Cardiovascular non-invasive monitoring (indirect BP monitoring)

Answer 2

Minimum requirement for all patients.
- change in systolic - change in myocardial oxygen requirements
- change in diastolic - coronary perfusion pressure.

Question 3

Cardiovascular invasive monitoring

Answer 3

Performed with electromechanical devices inserted into the pt body.
- Arterial pressure monitoring (ART)
- Central venous pressure monitoring (CVP)
- Transesophageal monitoring (TOE)

Question 4

Blood pressure direct monitoring

Answer 4

Involves cannulation of an artery to provide continuous measurement of arterial blood pressure.
- required when pt is at risk of haemodynamic instability

Question 5

ECG monitoring

Answer 5

• Produces a continuous waveform of the pt cardiac electrical activity to enable an assessment of their current physiological state.
• Assess the electrical mechanism and rate, and demonstrates dysfunctional rhythms that would have an effect on the CO.

Question 6

Arterial pressure monitoring

Answer 6

• Invasive provides beat-to-beat information with sustained accuracy
• Involves the cannulation of an artery measuring the true arterial pressure, and the connection too an external pressure transducer.

Question 7

Central venous pressure monitoring

Answer 7

Inserted prior to commencement of anaesthesia.
- measure R) heart filling pressure as a guide for intravascular filling
- administer drugs
- IV access in pt with poor veins.

Question 8

Respiratory monitoring - Capnography

Answer 8

Graphical representation of expired C02 (end tidal C02).
- assists anaesthetic team in early detection of technical catastrophes or changes in pt respiratory, circulatory or metabolic condition.
- initial indicator of malignant hyperthermia
- normal is 35-45mmHg

Question 9

Respiratory monitoring - Pulse ox

Answer 9

measures hB oxygen saturation (Sa02).
- detects differences in absorption of oxygenated and deoxygenated blood.

Question 10

Thermoregulation monitoring

Answer 10

Body uses a series of graded, corrective approaches to regulate and maintain normothermia.
- non-invasive temperature monitoring
- oesophageal temperature probe
- pulse oximetry

Question 11

Neurological monitoring

Answer 11

Performed by measurement of electrical activity in the brain by means of:
- EEG
- Sensory and motor evoked potentials (Eps)
- Electromyography (EMG)

Question 12

Neuromuscular blockage monitoring

Answer 12

• Pharmacological agents are used to reverse the effects of muscle relaxants.
• Use of a nerve-stimulator monitor measures the responses of neuromuscular function

Question 13

Inadvertent perioperative hypothermia (IPH)

Answer 13

a core temp below 36.
- must be addressed during perioperative period

Question 14

Complications of IPH

Answer 14

• increased recovery time
• increased wound infections due to suppression of immune system
• impaired cardiac function

Question 15

maintenance of normothermia

Answer 15

• control OR temp
• gaming IV fluids
• overhead heating lamp
• forced-air warming devices
• avoid exposure of pt
• pre-warming pt