Support and monitoring

Question 1

Are you legally required to have an anaesthetics monitoring sheet?

Answer 1

yes

Question 2

What should be on the anaesthetics monitoring sheet?

Answer 2

• Record exact mg of drugs given
• Assess risk for patient
• Record as many parameters as possible
• Note events occurring
• Assess recovery and analgesia

Question 3

What should be observed during basic monitoring?

Answer 3

–	muscle relaxation: neck muscle tone
–	eye rotation/pupil changes
–	jaw tone
–	whisker, pedal reflex
–	anal tone 
–	Mucous membrane colour
–	CRT
–	Toe-web/core temperature

Question 4

What should be observed during pulmonary monitoring?

Answer 4

– monitor breathing rate, rhythm, nature and effort
– observe bag and chest excursions
– mm colour

Question 5

What is the threshold for cyanosis?

Answer 5

The threshold for cyanosis is a reduced hemoglobin content of 5 g/dL in the capillary, which can occur at varying values of arterial oxygen saturation (SaO2) and arterial hemoglobin content
Remember: if there is cyanosis it is an emergency situation and the animal is severely hypoxic

Hb of 15g/dL (PCV 45%) Cyanosis may start to manifest at SpO285% - no other signs
Haemoglobin of 9 g/dL (PCV 27%)
The threshold SaO2 level for cyanosis is lowered to about 73% (PaO2 38 mm Hg), the patient would certainly have other signs

Question 6

How does pulse ox work?

Answer 6

Probe (transmitter and receiver of IR and red light transilluminates a pulsatile arteriolar bed)
• Computer software analyses absorption of light
• Oxyhaemoglobin & reduced haemoglobin absorb more IR and red light respectively
• A ratio is calculated corresponding to % haemoglobin saturated with oxygen

Question 7

How is the haemoglobin saturation SPO2% (reading from pulse oximeter) related to PaO2 (partial pressure of oxygen in the blood)?

Answer 7

Oxygen content is dependent on both SaO2 and PaO2

• Oxygen content = (1.39 x Hb x SPO2%) + (0.003 x PaO2)

Question 8

What is analysed in blood gas analysis ?

Answer 8

–	pH
–	HCO3
–	PCO2
–	PO2
Capnography – a good alternative for (PACO2)

Question 9

What is CVP?

Answer 9

Central Venous Pressure (CVP)
– Long jugular catheter
– Indicates filling pressure of the heart
– Affected by contractility and circulating blood volume

Question 10

What do increases and decreases in CVP mean?

Answer 10

Central Venous Pressure (CVP)
– Long jugular catheter
– Indicates filling pressure of the heart
– Affected by contractility and circulating blood volume