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Patient Monitoring 23 November 2008 Elvin  Cruz, MD, MS Med ETT Anesthesiologist Roizen: Essence of Anesthesia Practice Stoelting, Miller: Basics of Anesthesia Morgan, Mikhail: Anesthesiology Faust: Anesthesiology Review
Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ASA Standards for Basic Anesthesia Monitoring ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ASA Standards for Basic Anesthesia Monitoring ,[object Object]
ASA Standards for Basic Anesthesia Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Automated oscillometric NIBP monitor ,[object Object],[object Object],[object Object],[object Object]
Automated oscillometric NIBP monitor From: http://egems.gehealthcare.com/geCommunity/monitor/faq_bedside/nbp_faq.jsp Threshold                                                                                
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Automated NIBP monitor complications
ECG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ECG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],R-R interval
Normal Sinus rhythm HR ~ 85 bpm Pulse Rate estimation HR = 1500/#small boxes in R-R interval HR = 300/#large boxes in R-R interval
Sinus   Tachycardia, HR ~ 135 Sinus Bradycardia, HR ~ 52
Monophasic VT (Ventricular Tachycardia), HR ~ 185 VFib (Ventricular Fibrillation)
Asystole Check pulse Check connections Verify other leads Multifocal PVCs (Premature Ventricular Contractions)
Pulse Oximetry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],                                                                         
Pulse oximetry ,[object Object]
Pulse oximetry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pulse Oximetry Limitations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pulse Oximetry Limitations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pulse Oximetry Limitations ,[object Object],SpO 2  number likely to be inaccurate
Capnography ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Capnography
Esophageal intubation
Inadequate seal
Hypoventilation
Hyperventilation
Airway obstruction
Curare cleft
Invasive BP or Arterial Line Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arterial Line Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arterial Line Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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20 patient monitoring