Monitoring in anaesthesia

Question 1

What are the essential vital signs monitored during anesthesia

Answer 1

Essential vital signs include heart rate, blood pressure, respiratory rate, oxygen saturation (SpO2), and temperature.

Question 2

Why is blood pressure monitoring important in anesthesia?

Answer 2

Blood pressure monitoring is critical to assess the patient’s hemodynamic status, ensuring adequate perfusion of vital organs during anesthesia

Question 3

: How is respiratory rate typically monitored during anesthesia?

Answer 3

Respiratory rate is often monitored using the anesthesia machine’s ventilator, capnography, and observation of chest movement.

Question 4

What is pulse oximetry, and what does it measure?

Answer 4

Pulse oximetry is a non-invasive method to measure oxygen saturation (SpO2) in the blood, reflecting the patient’s oxygenation status.

Question 5

What can cause inaccurate pulse oximetry readings?

Answer 5

Factors such as poor perfusion, movement, nail polish, and external light interference can cause inaccurate SpO2 readings

Question 6

What does capnography measure?

Answer 6

Capnography measures the concentration of carbon dioxide (CO2) in exhaled air, providing an end-tidal CO2 (EtCO2) value that reflects ventilation.

Question 7

Why is capnography important in anesthesia?

Answer 7

Capnography is important for assessing the adequacy of ventilation, detecting airway obstructions, and monitoring respiratory status in real-time.

Question 8

What does an elevated end-tidal CO2 (EtCO2) indicate?

Answer 8

An elevated EtCO2 may indicate hypoventilation, increased metabolic rate, or rebreathing of exhaled gases.

Question 9

What can cause a sudden drop in EtCO2 during anesthesia?

Answer 9

A sudden drop in EtCO2 may indicate disconnection of the breathing circuit, extubation, or cardiovascular collapse.

Question 10

What are the normal ranges for end-tidal CO2 (EtCO2)?

Answer 10

Normal EtCO2 levels range between 35-45 mmHg.

Question 11

What is the purpose of ECG monitoring during anesthesia?

Answer 11

ECG monitoring detects and records the electrical activity of the heart, helping to identify arrhythmias, ischemia, and other cardiac events.

Question 12

What does the P wave on an ECG represent?

Answer 12

The P wave represents atrial depolarization, the electrical activation of the atria.

Question 13

What does the QRS complex on an ECG signify?

Answer 13

The QRS complex represents ventricular depolarization, which leads to ventricular contraction.

Question 14

What does ST-segment elevation on an ECG suggest?

Answer 14

ST-segment elevation may suggest myocardial ischemia or infarction, requiring immediate attention.

Question 15

How can arrhythmias be identified using ECG in anesthesia?

Answer 15

Arrhythmias can be identified by irregular heartbeats, abnormal QRS complexes, or irregular P waves on the ECG trace.

Question 16

What are the phases of the capnography waveform?

Answer 16

The capnography waveform has four phases:

Phase I: Baseline (inspiration, no CO2).
Phase II: Expiratory upstroke (beginning of exhalation, CO2 rises).
Phase III: Alveolar plateau (end of exhalation, CO2 levels off).
Phase IV: Inspiratory downstroke (rapid decrease, inhalation start

Question 17

What does a “shark-fin” pattern on the capnography waveform indicate?

Answer 17

A “shark-fin” pattern (slanted Phase II) on the capnography waveform indicates bronchospasm or airway obstruction, commonly seen in conditions such as asthma or COPD.

Question 18

What does an absence of a capnography waveform suggest?

Answer 18

An absent capnography waveform suggests either a disconnection in the circuit, a blocked endotracheal tube, esophageal intubation, or no CO2 production (e.g., cardiac arrest).

Question 19

How is capnography used to confirm correct endotracheal tube placement?

Answer 19

The presence of a continuous capnography waveform after intubation confirms that the endotracheal tube is in the trachea, as exhaled CO2 is detected. Absence of CO2 may indicate esophageal intubation.

Question 20

How does rebreathing of CO2 affect the capnography waveform?

Answer 20

Rebreathing of CO2 results in an elevated baseline on the capnography waveform, as CO2 is present at the start of the next breath, preventing the baseline from returning to zero

Question 21

What does a gradually rising EtCO2 trend during surgery indicate

Answer 21

A gradually rising EtCO2 trend may indicate hypoventilation, rising metabolic demands (e.g., fever or sepsis), or rebreathing of exhaled CO2.

Question 22

What role does capnography play in monitoring during cardiopulmonary resuscitation (CPR)?

Answer 22

During CPR, capnography helps assess the effectiveness of chest compressions and provides early indication of return of spontaneous circulation (ROSC) through sudden increases in EtCO2 levels.

Question 23

What is Standard 1 according to ASA standards for basic anesthetic monitoring

Answer 23

The anesthesia provider will be present throughout the procedure

Question 24

What is Standard 2 according to ASA standards for basic anesthetic monitoring

Answer 24

states that the patients oxygenation, ventilation, circulation and temperature will continually monitored

Question 25

How does a pulse oximeter work?

Answer 25

A pulse oximeter works by emitting red and infrared light through a pulsating arterial bed (such as a fingertip). Oxygenated hemoglobin absorbs more infrared light, while deoxygenated hemoglobin absorbs more red light. The device then calculates oxygen saturation (SpO2) by comparing the absorption of the two wavelengths and uses the pulsatile nature of arterial blood flow to estimate the pulse rate.