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Transcript of Monitoring anaesthesia
Diagnose rhythm disturbances
Heart rate Limitations No information about cardiac output Pulse Oximetry Detects the pulsitile flow of blood in peripheral tissues
Affected by movement, pigmentation and local blood flow. Doppler Doppler Simple to use
Limited to systoic only
Labour intensive Oscillometric Oscillometric Automated
Systolic, diastolic and mean
also Heart rate
Some systems fail at low blood pressure or irregular heart rhythms Direct arterial Direct artieral blood pressure Advanatages Immediate beat by beat readings.
High degree of accuracy in all situations Disadvantages Cost of equipment
Arterial access required Measure end tidal CO2 Mainstream 2 SYSTEMS -
Side stream and Mainstream
Display graphic wave form or numbers only A sensor attached to the top of the ET tube Side stream Sample of gas withdrawn from the end of the ET tube and transferred to the analysis unit Capnogram Normal capnogram Capnogram Rebreathing Hypoventilation What can it tell you? Hyperventilation
Disconnection Steady small rise in ETCO2. Often the respiratory rate is a little slow as well. Bad things SUDDEN fall in ETCO2 but with a 'normal' trace remaining.
Impending respiratory arrest
Cardiac arrest / collapse without respiratory arrest (yet) Hyperventilation Steady small FALL in ETCO2 Flat-disconnection, oesophageal intubation, dead. Failure to return to baseline zero between breathes. Slow increase in ETCO2 Basic Monitoring Eye Hand Pulses
Anaesthetic machine! Ears Breathing
Heart sounds ECG Electrical activity only! Pulse ox.