Monitors Flashcards
Giving vasodilator affect on map and sbp
The maps would both decrease the same, however the sbp would decrease more distally and less so at the aorta
Natural frequency vs dampening
Essentially they are opposites, the more frequency the more points to measure the less dampening
Dampening is caused by
Things that affect the monitor
Lengthining the tube, air bubbles, multiple or loose connections and decrease in frequency
Dampening is the oppsoite of frequency so these things all increase dampening and decrease frequency
Arterial line thrombus
A larger catheter, propylene glycol, high dose vasopressor, artery size, and puncture attempts and female gender
Blood pressure cuff oversized
Oversized: has to have width greater then 40-50% of the circumfrrnce of arm, 20% greater diameter, the bladder length encircling 60% of arm
Less pressure is needed with over sized cuff leading to under estimation
No evidence of inappropriately placed cuffs leads to nerve damage or ischemia
Hypothermia
Causes osbourne waves
Digitalis
Can cause salvatorndali mustache sign, pvc and av block
Wedge pressure
Estimates lvedp
This can be affected by cardiac compliance. If muscle is stiff then pressure will grow disproportionately to volume.
Likely site of central line insertion with chylothorax
Left subclsvian
Cleanest site of central line insertion
Subclavian, then ij, then femoral
Contraindication to pulm artery catheter
Presene of a lbb because the catheter can cause a rbb causing completr heart block
Map and sbp aorta vs wrist
The map will be higher at aorta and decrease slightly as you get closer to wrist allowing blood to flow
The wave form exaggerates as you move farther away making systolic blood pressures higher
Blocking artert of adamkovicz resembles
Anterior spinal artery so motor gets blocksd
Best core
Typanic
Bladder and pulm artery also possibles
Hypothermia in or
Phase on is due to vasodilation and redistribution from core to periphery
Phase two is further redis and conduction
Phase three is steady state 4-6 hrs in
Anesthetic affect on evoked potentials
Brainstem auditory is least affected then ssep then mep and then visual
Minimum o2 needed before i2 pressure sensor valve turns off
25 psi
The second stage of o2 pressure regulator drops o2 down to 16
Ohmeda bellows
Use o2
Rotatmeter read in middle ofnpin
Ball float
Splitting ratio
Depends on anesthetic agent temp chosen vapor conc to be deliveredand saturated vapor pressure
Fail safe vs o2 analyzer
Fail safe makes sure there is a 25 psi o2 with n20
Oxygen analyzer avoids hypoxic gas mixtures
When n20 is used w vaporizer
Some n20 is absorbed into the vaporizing chamber and so a little less is delivered but then when you shut off n20 the n20 leaves the gas fluid and transiently causes an increase of vaporizor output
Capnogran
If co2 doesnt return to zero, patient rebreathing co2. Differential includes incompetent expiratory valve exhausted co2 or gas channeling through co2 absorbent
If inspiratory downstroke is slanted think insp valve problem
Most common complication of direct laryngoscopy
Dental trauma, should get xray to see where tooth went and dental consult
