NonCV Monitors

Question 1

Precordial Stethoscope

Answer 1

very old school

- ensure chest is rising and bilateral movement

Question 2

Pulse Ox - Mandatory

Answer 2

transmittance vs reflective oximetry
- Oxyhemoglobin (960 nm)
- Deoxyhemoglobin (660 nm)
Red/Infrared ratio = inversely proportional

Question 3

Carbon Monoxide

Answer 3

absorbs at the same wavelength

- therefore you won’t see a drop in sats with CO poisoning

Question 4

Capnography

Answer 4

determined by the CO2 absorption of infrared light

• it can rapidly and reliably detect esophageal intubation
• dips in tracing = spontaneous effort
• not zero = incompetent valve in system
• normal gradient between EtCO2 and PaCO2 is about 2-5

Question 5

BIS monitor

Answer 5

100-80 = awake/alert
60-80 = sedation
40-60 = general anesthesia
0-40 = deep anesthesia (isoelectric)

Question 6

Evoked Potentials

Answer 6

asses the neurologic function by measuring EP responses to pathway stimulation
*detect ischemia to the spinal cord and cerebral cortex

Question 7

SEP and MEP

Answer 7

SEP - somatosensory (peripheral to central)

MEP- motor (central to peripheral)

Question 8

Problems with EP

Answer 8

• volatile anesthetics diminished EPs

- can’t use NMB

Question 9

Temperature

Answer 9

Hypothermia - delayed drug metabolism, hyperglycemia, vasoconstriction, impaired coagulation

Hyperthermia - tachycardia, vasodilation, neurologic injury

Question 10

Urinary Output

Answer 10

need a catheter to accurately predict

- UOP is a bad surrogate of renal perfusion

Question 11

Peripheral Nerve Stimulator

Answer 11

monitors the NMJ during blockade

Question 12

Train of Four and correlate to receptors

Answer 12

0-1 Twitch = 100% occupied
2 Twitches = 90% occupied
3 Twitches = 80% occupied
4 Twitches = 70% occupied