Monitoring in Anaesthesia Flashcards
Name four basic components of patient ,monitoring in anaesthesia
Inspired oxygen
Airway patency
Breathing
Circulation
State why It is important for temperature to be monitored in anaesthesia.
Hyperthermia can also occur and malignant hyperthermia /hyperpyrexia (MH) is a potentially fatal complication of anaesthesia.
Cold theatres can lead to hypothermia especially in infants and wet exposed patients
State six measures of ventilation
Tidal volume, respiratory rate, inspiratory time, flow rate, I : E ratio, minute volume
List 5 basic monitors of the machine/patient interface
• Oxygen analyser for measurement of O2 concentration at common gas outlet of the
machine.
• Ventilation: Tidal volume, rate, inspiratory time, flow rate, I : E ratio, minute volume,
etc.
• Airway pressure
• Capnograph / disconnect alarm
• Agent monitor for measurement of inspired and expired vapour concentration
List three monitors of oxygen and gas supply.
Pressure gauges
Oxygen analysers
Flowmeters or Rotameters: Monitors oxygen, nitrous oxide and air to ensure correct fresh gas flow (FGF
What is the pressure for oxygen cylinders?
14 000 kPa(140 bars which is 2000 psi)
Note: This is very high pressure
What is the pressure found in the pipelines?
400kPa(4 bars which is approximately 60psi)
State two readings that the oxygen analysers monitor.
Inspired % - At the fresh gas flow outlet (confirms the gas is O2 if it reads ± 100 %)
Inspired and expired %- Aspirated at catheter mount (patient end of breathing circuit)
List 8 components of monitoring the patient wellbeing by means of observation, palpation and auscultation.
Airway, breathing, circulation, oxygenation, temperature, depth of anaesthesia, fluid balance and blood loss
List 6 common non invasive clinical monitors
• ECG
• Non Invasive Blood pressure
• Capnograph
• Pulse oximeter
• Temperature
• Nerve stimulator
List three standard monitoring for all procedures, even awake patients undergoing local anaesthesia
EKG, non invasive BP and pulse oximetry
List clinical monitors required for general anaesthesia.
• ECG
• Non Invasive Blood pressure
• Capnograph
• Pulse oximeter
• Temperature
•Measurement of inspired oxygen concentration
Note: Nerve stimulators are added if muscle relaxants are used
State 5 instances where invasive monitors are employed.
Major surgeries where there may be haemodynamic instability and/or major blood loss,
Critically ill patients,
Patients with severe background systemic disease,
Truma patients, and
Patients withcardiovascular compromise
What is the easiest and simple monitor of fluid balance?
Urinary catheters
Note: They are standard monitors in spinal anaesthesia and long procedures
Outline 4 common invasive clinical monitors used in anaesthesia
Urinary catheters: Fluid balance monitor
Central line: Useful for blood sampling and infusing/administering dangerous drugs such as inotropes, used to measure central venous pressure but not common nowadays)
Arterial lines: It provides real time, beat to beat monitoring of systemic blood pressure;
Transesophageal echo: provides real-time visualisation of cardiac function.
State two functions of the central venous line.
Monitoring of the actual central venous pressure(rare these days)
Useful for blood sampling and infusing / administering potentially
dangerous drugs such as inotropes.
Where do we typically insert the arterial line?
Radial artery
Note: Once placed provide for
non-traumatic and easy sampling of arterial blood for blood gas analysis
State the device used to monitor airway pressure and state the desired airway pressure.
Manometer:
Preferred value: <35 hPa to prevent barotrauma
State three clinical ways to confirm clear airway
Confirmed by “feel” (lack of vibration in the mask), by listening at the airway or at the end of the endotracheal tube, or by using a stethoscope over the trachea.
What is a clinical monitor of respiratory efforts in Anaesthesia?
Observation of excursion of chest and reservoir bag
State the normal tidal volume and minute volume.
TV: 6-10
MV: 80-100
State two most important spirometry values used for respiratory monitoring.
Tidal volume and minute volume
What does the pulse oximetry measures?
This measures % O2 saturation of haemoglobin in the peripheral skin arterioles, not the PaO2
List four factors that influence O2 delivery to tissues.
FIO2, Airway, Breathing, and Circulation
