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Anaesthesia > Monitoring in Anaesthesia > Flashcards

Monitoring in Anaesthesia Flashcards

1
Q

What is the primary purpose of monitoring in anaesthesia?

A

To warn of any impending disaster and ensure the well-being of the patient.

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2
Q

What is the difference between continuous and continual monitoring?

A

Continuous monitoring occurs without interruption, while continual monitoring is repeated at regular intervals.

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3
Q

What are the two main types of monitoring?

A

Non-invasive and invasive monitoring.

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4
Q

For which types of anaesthesia is monitoring recommended?

A

Monitoring is recommended for all general, regional anaesthesia, and monitored anaesthetic care.

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5
Q

What is the standard for basic intraoperative monitoring?

A

Presence of qualified anaesthetic personnel throughout the procedure.

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6
Q

What are the key parameters evaluated in intraoperative monitoring?

A

Oxygenation, ventilation, circulation, and body temperature.

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7
Q

What are the types of monitoring methods used during surgery?

A

Clinical and equipment monitoring.

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8
Q

What is the importance of continuous anaesthetist presence during surgery?

A

To immediately respond to any changes in the patient’s condition.

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9
Q

Name the standard monitoring equipment used in anaesthesia.

A

ECG, blood pressure, precordial stethoscope, capnography, pulse oximeter, temperature, and urine output.

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10
Q

How is respiratory system monitoring conducted clinically?

A

By observing colour, movement of the reservoir bag, chest excursion, and auscultation.

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11
Q

What is the function of a pulse oximeter?

A

To non-invasively measure oxygen saturation in arterial blood and pulse rate.

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12
Q

How does a pulse oximeter work?

A

It uses differential wavelengths of red and infra-red light absorbed by deoxy-haemoglobin and oxy-haemoglobin.

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13
Q

What is the normal oxygen saturation range measured by a pulse oximeter?

A

97–100%.

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14
Q

How does the presence of oxygenated blood affect pulse oximeter readings?

A

It increases the absorption of infra-red light.

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15
Q

What does a low reading on a pulse oximeter indicate?

A

It may indicate the presence of more deoxygenated blood or issues such as difficult intubation.

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16
Q

What does the plethysmograph on a pulse oximeter show?

A

It shows the volume of blood flow during systole.

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17
Q

What information does the pulse oximeter display?

A

Pulse rate and oxygen saturation of the blood.

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18
Q

Name different types of pulse oximeter probes.

A

Probes include LED, ear, finger, toe, and bridge of the nose types.

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19
Q

What does pulse amplitude indicate on a plethysmograph?

A

It indicates tissue perfusion.

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20
Q

What factors can affect the accuracy of a pulse oximeter?

A

Factors include COHb, metHb, probe position, peripheral vasoconstriction, ambient light, dyes, and nail polish.

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21
Q

List some common problems associated with pulse oximetry.

A

Problems include no direct info about O2 delivery, response time lag, and skin pressure sores.

22
Q

Why is an oxygen analyser essential in anaesthesia?

A

To monitor the fraction of inspired oxygen (FiO2) in the gas mixture.

23
Q

What is capnography, and what does it measure?

A

Capnography measures expired CO2 concentration and assesses ventilation adequacy.

24
Q

What are the two types of sampling used in capnography?

A

Mainstream and sidestream.

25
Q

How does capnography assess ventilation adequacy?

A

By showing the concentration of CO2 in the exhaled breath.

26
Q

What are the clinical uses of capnography?

A

Measures respiratory rate, identifies oesophageal intubation, and allows ventilation adjustments.

27
Q

What are the phases of capnography?

A

Phase I: Dead space gas; Phase II: Dead space + alveolar gas; Phase III: Alveolar gas; Phase IV: Inspiration.

28
Q

What are the normal ETCO2 values?

A

3.5 – 5.7 kPa.

29
Q

List some factors that can increase ETCO2.

A

Rebreathing, hypoventilation, sepsis, malignant hyperthermia, thyroid storm.

30
Q

List some factors that can decrease ETCO2.

A

Disconnection, cardiac arrest, pulmonary embolism, hyperventilation, hypoperfusion, hypothermia.

31
Q

What are some common capnography tracing abnormalities?

A

Elevated baseline (rebreathing), slow phase II rise (COAD), curare cleft (recovery from NMB).

32
Q

What is the purpose of an O2 failure warning device?

A

It provides an auditory alarm, cuts off anaesthesia gas supply, and switches circuits to air.

33
Q

What does a precordial stethoscope monitor?

A

It monitors the position of the endotracheal tube, ventilation, heart sounds, and rhythm.

34
Q

What is an oesophageal stethoscope, and when is it contraindicated?

A

An oesophageal stethoscope can also measure core temperature but is contraindicated in oesophageal varices.

35
Q

What clinical signs are monitored in the cardiovascular system?

A

Pulse rate, rhythm, volume, heart sounds, and extremity perfusion.

36
Q

What does an electrocardiogram (ECG) monitor?

A

Electrical activity of the heart.

37
Q

What are the uses of ECG in anaesthesia?

A

To determine heart rate, diagnose arrhythmias, and detect ischaemia.

38
Q

What are some inaccuracies that can occur with ECG monitoring?

A

Poor electrode placement, muscle activity, and electromagnetic interference.

39
Q

What does arterial blood pressure reflect in a patient?

A

Reflects organ blood flow, with systolic, diastolic, and mean arterial pressure values.

40
Q

What are the different methods for detecting arterial blood pressure?

A

Palpation, auscultation, oscillotonometry, and plethysmography.

41
Q

What are the complications of invasive arterial pressure monitoring?

A

Haematoma, thrombosis, infection, nerve damage, and inadvertent drug injection.

42
Q

What does central venous pressure (CVP) indicate?

A

It reflects the blood volume (preload) and right heart function.

43
Q

What are the indications for measuring CVP?

A

Fluid management, venous access, caustic drug infusion, TPN, and air embolism aspiration.

44
Q

What complications can arise from CVP monitoring?

A

Air embolism, dysrhythmias, pneumothorax, nerve damage, tamponade, and infection.

45
Q

Why is monitoring urine output important during surgery?

A

To monitor kidney function and manage fluid balance.

46
Q

How can the depth of anaesthesia be clinically assessed?

A

Through Guedel’s stages, and signs of sympathetic stimulation.

47
Q

What is the BiSpectral Index (BIS) used for?

A

To monitor the depth of anaesthesia using EEG and EMG technology.

48
Q

What is the purpose of neuromuscular junction monitoring?

A

To assess neuromuscular block and response to nerve stimulation.

49
Q

What are the standard sites for core temperature measurement?

A

Lower oesophagus, tympanic membrane, nasopharynx, bladder, and rectum (unreliable).

50
Q

How is blood loss monitored during and after surgery?

A

Through clinical signs, gravimetric measurements, and visual estimates.

Anaesthesia (16 decks)

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