gpt monitoring

Question 1

What are the key clinical indicators used to assess depth of anaesthesia in veterinary patients?

Answer 1

• Cranial nerve reflexes (e.g., palpebral)
• Muscle tone
• Cardiovascular parameters
• Response to surgical stimulation

Question 2

How does ketamine affect typical signs of anaesthesia depth?

Answer 2

• Maintains palpebral reflex
• Eyes remain central due to preserved muscle tone

Question 3

Why is the corneal reflex not a reliable indicator of anaesthetic depth?

Answer 3

• It may still be present after cardiac arrest
• Risk of trauma from repeated elicitation

Question 4

What are the main methods of clinical cardiovascular monitoring during anaesthesia?

Answer 4

• Palpation of apex beat
• Auscultation
• Pulse palpation
• Mucous membrane colour
• Capillary refill time (CRT)

Question 5

What are the clinical methods to monitor respiratory function during anaesthesia?

Answer 5

• Observation of reservoir bag and chest excursions
• Assessment of respiratory rate, depth, and pattern

Question 6

What does ECG monitoring provide during anaesthesia and what are its limitations?

Answer 6

• Records electrical activity of the heart
• Identifies arrhythmias and monitors rhythm
• Does NOT provide mechanical function or cardiac output information

Question 7

What are the phases of a normal capnogram and what do they represent?

Answer 7

• A: Inspiratory baseline (dead space gas)
• B: Expiratory upstroke (mix of alveolar and dead space)
• C: Expiratory plateau (alveolar gas)
• D: Inspiratory downstroke

Question 8

List clinical applications of capnography in anaesthesia monitoring.

Answer 8

• Assess ventilation adequacy
• Detect oesophageal intubation
• Identify disconnections or obstructions
• Monitor circulatory function and detect malignant hyperthermia

Question 9

What are the advantages and disadvantages of mainstream vs side stream capnographs?

Answer 9

• Mainstream: no delay, more accurate in small patients, but bulky and sensitive to damage
• Side stream: flexible, can monitor multiple gases, slight delay, risk of obstruction and gas dilution

Question 10

What can cause increased or decreased ETCO2 during anaesthesia?

Answer 10

• Increased: sepsis, hypoventilation, increased metabolism
• Decreased: hyperventilation, hypotension, cardiac arrest, pulmonary embolism

Question 11

How does pulse oximetry work and what does it measure?

Answer 11

• Measures arterial oxygen saturation (SpO2) and pulse rate
• Uses red and infrared light absorption to determine haemoglobin oxygenation

Question 12

What factors can interfere with accurate pulse oximeter readings?

Answer 12

• Poor probe placement
• Peripheral vasoconstriction
• Anaemia, bright lights, diathermy, shivering, abnormal haemoglobins

Question 13

What are the key differences between Doppler and oscillometric blood pressure monitoring methods?

Answer 13

• Doppler: measures systolic pressure, good for small animals, requires operator
• Oscillometric: provides systolic, diastolic, and mean, more automated but less reliable in small or unstable patients

Question 14

Why is direct arterial blood pressure monitoring considered the gold standard?

Answer 14

• Provides continuous, real-time beat-by-beat measurement
• Allows analysis of stroke volume, SVR, and contractility
• More accurate but requires technical skill and has risks like bleeding and infection

Question 15

What is the importance of anaesthetic record keeping and what should it include?

Answer 15

• Essential for detecting trends and as a medico-legal document
• Should include data recorded at least every 5 minutes
• Use standardised charts like those from the Association of Veterinary Anaesthetists