Monitoring ECG Flashcards
(20 cards)
Why monitor?
provide better patient care via early diagnosis and treatment
prevent mortality and morbidity
protect the anesthetist (record keeping)
How often should you monitor intra-operatively?
every 5 mins
4 key things to monitor
circulation
oxygenation
ventilation
temperature
T/F: only monitor blood pressure in high risk patients
False, monitor BP in all patients
2 ways to monitor circulation
ECG and blood pressure
3 things to consider when assessing a pulse
rate, rhythm, quality
T/F: use arteries proximal to the heart to measure a pulse
false, use a distal artery (if it feels strong, likely indicates good CO)
3 arteries for pulse palpation in large animals
auricular
transverse facial
facial
T/f: an ECG detects a heart’s contractility
false - records heart’s electrical activity from the surface of the body but doesn’t indicate the heart is actually contracting
Describe type A cardiac innervation
purkinje fibres excite endocardium and excitation spreads via muscle fibers
current flow is base to apex
ECG: positive R wave
small animals, humans
Describe type B cardiac innervation
purkinje fibers deeply penetrate myocardium and most muscle fibres are excited simultaneously, most vectors cancel each other
current flow is apex to base
ECG: negative S wave
horses, ruminants, pigs
which lead is preferred in healthy small animals?
lead 2 - yields tallest R wave
which lead is preferred for animals with type B innervation?
lead 1
T/F: it is safe to replace ECG gel with alcohol
false, may burn in flames if you need to defibrillate patients
4 steps for systematic examination of ECG
- determine HR (ventricular rate)
- evaluate rhythm
- assess complexes and intervals
- determine mean electrical axis
Best way to determine HR?
auscultate
2 common arrhythmias seen under anesthesia
sinus bradycardia and tachycardia AV blocks (1st and 2nd degree)
First line of treatment for ventricular arrhythmias?
Lidocaine IV
T/F: when HR is high, BP sky rockets
false, it plummets because there is not enough time for ventricular filling
T/F: always treat a ventricular arrhythmia during anesthesia
False, essentially only treat if it is affecting hemodynamics
