Flashcards in Chpt. 5 - Key Points Deck (12):
Who published guidelines for anesthetic monitoring intended to help veterinary anesthetists make sound monitoring decisions?
The American College of Veterinary Anesthesiologists (ACVA)
What does the anesthetist have to do during any anesthetic procedure?
The anesthetist must monitor the animal closely to ensure that the patient is safe and that the degree of central nervous system (CNS) depression or anesthetic depth is appropriate.
What is effective monitoring based on?
It is based on the principle that at any given anesthetic depth, monitoring parameters show predictable responses. Much discernment is required on the part of the anesthetist to interpret the significance of these parameters, however.
What gives the anesthetist a framework for meaningful interpretation of monitoring parameters?
Knowledge of the anesthetic stages and planes.
Name the objectives of surgical anesthesia.
- patient does not move
- patient is not aware
- patient does not feel pain
- patient has no memory of procedure afterwards
- patient has stable cardiopulmonary function
Name the three classifications of physical monitoring parameters.
1. Vital signs
3. Other indicators of anesthetic depth
What is most helpful to determine, if the patient is safe?
Vital signs (incl. HR and rhythm, pulse strength, CRT, MM color, RR and depth, and temperature)
What reflexes and other indicators are most helpful to determine if the anesthetic depth is appropriate?
- Reflexes (incl. the laryngeal, swallowing, pedal, palpebral, corneal, and PLR)
- Other indicators ( incl. spontaneous movement, muscle tone, eye position, pupil size, response to surgical stimulation, lacrimation, salivation, and nystagmus)
How are physical and machine monitoring parameters grouped?
They can be grouped according to whether they assess circulation, oxygenation, ventilation, or anesthetic depth.
Why is monitoring equipment a good idea?
Monitoring equipment, although not mandatory for effective patient monitoring, generates data (incl. oxygen saturation, arterial BP, cardiac electrical activity, inspired and expired CO2 levels, blood gases, HR, RR, and tidal volume) that help the anesthetist accurately assess patient status.
This equipment often warns of impending problems early, so that the anesthetist can take action before they reach crisis level.
What does effective monitoring require?
It requires the anesthetist to memorize normal monitoring parameters and to know what levels signal a need to inform the VIC.