Monitoring the anaesthetised patient Flashcards
(40 cards)
What should be recorded during anaesthesia?
patient’s signalemnt
drugs administered
fluid therapy
parameters every 5-10 minutes (LEGAL MAX)
important events
complications
vital parameteres of the animal in recovery)
Why do we monitor our patients?
to maintain body as cloas as possible to physiological normality
to maintain adequate depth of anaesthesia
to promote patient and personnel safety
legal requirement
How do we monitor?
listen for: ventilation sounds, alarms, gas leaks
look at: eye position, chest movements, mucous membrane colour
feel: pulse quality, rate and rhythm, jaw tone, reflexes
smell: volatile agent (leak or disconnection)
How can we monitor the CNS/depth of anaesthesia?
assessment of reflexes
eye position, movement of globe, lacrimation, pupil size
Electroencephalography EEG
Bispectral index BIS
What are the factors determining tissue perfusion and oxygen delivery?
cardiac output
stroke volume (blood volume, vasc. resistance)
heart rate (nerves, hormones)
What do we monitor for arterial blood pressure?
MAP
CO
Systemic vascular resistance
When is systolic arterial pressure considered hypertensive?
over 160 mmHg
When is the arterial blood pressure considered hypotensive?
systolic arterial pressure under 90
mean art pressure under 60 (70 for horses)
diastolic art press under 40
What do we use to quickly check arteriall blood pressure?
feel HR and pulse quality
What are non invasive and invasive ways to monitor arterial bp?
noninvasive: oscillometry, doppler
invasive: direct arterial bp
What do we know about oscillometry?
accuracy depends on cuff
cuff leveled with heart
gives sap, map, dap
tendency of under estimation
What do we know about doppler?
accuracy depends on cuff, leveled with heart
only gives SAP
in cats value is between SAP and MAP
What do we know about IBP?
gold standard
arterial catheter
transducer at lvel of heart
How do we troubleshoot low BP during anaesthesia?
asses depth of anaesthesia and REDUCE if possible
IV fluid therapy
vasopressors (positive inotropes, vasoconstrictors)
What should we avoid during hypotension in anaesthesia?
NSAIDs
What do we observe to monitor the resp system?
breathing rate
breathing rhythm
tidal volume/ depth of each breath
mucous membrane
What is the equation for minute volume?
MV= TV x RR
What does white mm indicate?
anaemia, intense vasoconstriction
What does yellow mm indicate?
jaundice, carotens
What does grey/purple/cyanotic mm indicate?
poor tissue oxygen delivery
What does navy blue mm indicate?
excess of nitrous oxide (severe cyanosis)
What does cherry red mm indicate?
carbon monoxide poisoning
What does mudy brown mm indicate?
metaHb (nitrite, paracetamol poisoning)
What does brick red/brown mm indicate?
systemic inflammation response, sepsis
