Standards of monitoring Flashcards
Is it every appropriate to leave an anaesthetised patient
‘Occasionally, an anaesthetist working single-handedly might be called upon to perform a brief life-saving procedure nearby. Leaving an anaesthetized patient in these circumstances is a matter for individual judgment. In such situations, the surgeon must stop operating until the anaesthetist returns. During the anaesthetist’s absence, observation of both the patient and the monitoring devices must be continued by a trained anaesthetic assistant. Any problems should be reported to the available medical staff.’
Monitoring during induction and maintenance of anaesthesia
- Pulse oximeter
- NIBP
- ECG
- Airway gases concentration: oxygen, carbon dioxide, vapour
- Airway pressure
Must also be available:
* Nerve stimulator whenever a muscle relaxant is used
* Means of measuring the patient’s temperature
Note may not be possible to attach all monitoring prior to induction (e.g. children) – attach ASAP and record reason for delay in notes.
Monitoring during recovery from anaesthesia
- Pulse oximeter
- NIBP
Must be immediately available:
* ECG
* Nerve stimulator
* Means of measuring temp
* Capnograph
Monitoring during patient transfer
During patient transfer, the standard of care and monitoring should be as high as that applied in the controlled operating theatre environment
Must be routinely commenced prior to transfer:
* O2 sats
* Arterial BP
* ECG
Additionally:
* Intravascular or intracranial pressure monitoring may be necessary in special cases
* Monitored oxygen supply of known content sufficient to last max duration of transfer
* If IPPV: expired CO2, airway pressure, tidal volume, respiratory rate
True or false: Current monitoring standards apply to anaesthetic practice under all clinical circumstances
False. Current standards apply to all anaesthetic practice except in emergency circumstances where appropriate life support measures may take precedence.
