Term
| Goal of anesthetic Monitoring |
|
Definition
| Ensure Adequate tissue perfusion w/ Oxygenated blood |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| ACVA Monitoring recommendations |
|
Definition
| Circulation, Oxygenation, Ventilation, Personnel, Medical record |
|
|
Term
|
Definition
- Legal Doc
- Continuous monitor
- Record every 5 min
- Alerts you to trends |
|
|
Term
| Circulation electrical vs. Mechanical activity |
|
Definition
| Electrical activity - the heart can have WITH OUT mechanical (pumping) = no CO |
|
|
Term
| Measures of Mechanical activity (circulation)) |
|
Definition
- Pulse pressure
- Mean art BP = MAP
- Central Venous pressure= CVP |
|
|
Term
| Measures of Electrical Activity |
|
Definition
|
|
Term
|
Definition
fine gauge wire
Stick on patch
skin staple
esophageal stethoscope
Clips can cause trauma |
|
|
Term
| How to monitor pulse pressures |
|
Definition
Palpation
Auditory - Doppler, Esophageal stethoscope, Pulse Oximeter |
|
|
Term
|
Definition
| = Difference between systole and diastole |
|
|
Term
| Is Pulse Pressure a good indicator of Mean Arterial Pressure? |
|
Definition
NOOOOOOO! pressure is difference between systolic and diastolic pressure
120 - 80 = pp of 40
80 - 40 = pp of 40
same pp but not a good indicator of Mean Art Press |
|
|
Term
| Areas to palpate for Pulse Pressure |
|
Definition
- Femoral artery
- Carpal (bottom) and Tarsal (top) arteries
- Lingual artery |
|
|
Term
| Auditory Pulse Monitoring |
|
Definition
| Use esophageal stethoscope or Doppler |
|
|
Term
|
Definition
MAP = CO * SVR
CO = SV * HR
SV = Contractility * Load |
|
|
Term
| What value would you like the MAP to be |
|
Definition
|
|
Term
| What drives the blood perfusion? |
|
Definition
|
|
Term
| What is the lateral force / unit area exerted on a vessel wall? |
|
Definition
|
|
Term
|
Definition
(Systolic press + Diastolic p + Diastolic Press) / 3 = MAP
This is why pulse pressure is a bad estimate |
|
|
Term
| 2 indirect (non-invasive) methods of getting Arterial BP |
|
Definition
- Manual - Doppler
- Automated - Oscillmetric method |
|
|
Term
|
Definition
| 40% of Limb circumference |
|
|
Term
|
Definition
| artificially lowers values |
|
|
Term
|
Definition
| artificially elevates values |
|
|
Term
| Where to place cuff on cats |
|
Definition
| Above elbow on medial side |
|
|
Term
| Where to place cuff on dog |
|
Definition
| distal forelimb (bottom) or Distal rearlimb (top) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Direct Arterial BP methods (Invasive) |
|
Definition
requires an arterial cath
two methods - Connect art cath to
1. Transducer to read w/ Occliscope
2. Pulsations can be read w/ Aneroid Manometer |
|
|
Term
| What is the measurement of the luminal pressure in the intrathoracic vena cava or RA |
|
Definition
| CVP - Central Venous Pressure |
|
|
Term
| CVP - Central Venous Pressure what does it reflect |
|
Definition
1. Ability of heart to pump returning blood
1. Adequacy of the circulating blood volume |
|
|
Term
|
Definition
Usually hook up to a
Water Manometer or
Transducer (most common) |
|
|
Term
|
Definition
| VOLUME - Use as a gauge for if you should give more or less Volume of fluids |
|
|
Term
| 3 ways to monitor Ventilation |
|
Definition
1. Observation (thoracic wall, breathing bag movement)
2. Auditory (Honker, Esophageal stetho)
3. Carbon Dioxide (BG, capnography) |
|
|
Term
|
Definition
- Too light or too deep
- Drug Induced
- Obese or Old
- Hypoxic
- Hyperthermic |
|
|
Term
| Reasons for Bradycardia/Apnea |
|
Definition
CNS Depression (Too deep)
Opoids
barbituates
propofol
after neruro procedures |
|
|
Term
| 2 measures of ventilation that use CO2 |
|
Definition
1. Arterial BG - Invasive
2, End Expired analysis = Capnography (non-invasive) |
|
|
Term
|
Definition
Instrument that measures end-tidal volume CO2 - ETCO2
Provides an estimate of arterial carbon dioxide partial pressure (PaCO2) |
|
|
Term
|
Definition
40-45 mmHg
- Can use end-expired CO2 to approx Arterial values of CO2 |
|
|
Term
| Reasons for Increased CO2 |
|
Definition
Hypoventilation
Overproduction
Rebreathing |
|
|
Term
|
Definition
Hyperventilation
Cardiac Arrest |
|
|
Term
| In the Capnography graph need to know when Inhale and Exhale |
|
Definition
Inhale at end of peak
Exhale at end of low
makes since CO2 rises when exhaling
CO2 decreases when inspiration begins |
|
|
Term
| If the Capnograph has an elevated base line = |
|
Definition
|
|
Term
| If the Capnograph continually gets smaller and smaller |
|
Definition
| Cardiac Arrest. Animal is still ventilating but Heart has stopped |
|
|
Term
| When you see little oscillations in the capnograph |
|
Definition
| are just cardiac contractions. The heart beats hit lungs and causes little tufts of CO2 |
|
|
Term
| Good Standard of Ventilation after blood gas |
|
Definition
|
|
Term
|
Definition
- Monitor resp and vent
- Verify tracheal intubation
- monitor rebreathing of CO2
- Predict survival for Cardiac Arrest |
|
|
Term
| 3 methods to monitor Oxygenation |
|
Definition
1. Mucous Membrane Color (non-invasive)
2. Art blood gas analysis (invasive)
3. Pulse Oximetry (non-invasive) |
|
|
Term
| Adequate Oxygenation depends on what 3 things |
|
Definition
1. Adequate Blood Oxygen
2. Adequate Hg content (pack cell volume)
3. Adequate Peripheral perfusion |
|
|
Term
| When will the pulse Ox alarm go off? |
|
Definition
| @ PO2 of 60mmHg = 90% saturation |
|
|
Term
| Checking MM color for Oxygenation |
|
Definition
- Not very sensitive
- Looking for Cyanosis
- occurs when unsat Hemoglobin > 5g /100mls
- Blood turns from red to blue
- |
|
|
Term
| What the Arterial Blood Gas Provides |
|
Definition
- Acid base
- Oxygenation
-Ventilation |
|
|
Term
| Can the pulse Ox tell you about ventilation? |
|
Definition
| NO- the pulse ox can not tell you if the animal is breathing |
|
|
Term
| What does Pulse Ox tell you |
|
Definition
The % od hemoglobin saturated with O2- ie: Oxygenation
Also monitors: Pulse rate, Pulse rhythm, CO |
|
|
Term
| The pulse ox machine can be interfered with by many things what are common ones. |
|
Definition
- Motion
- Low perfusion
- Optical Interference
- Anemia
- Carbon Monoxide
- Methemoglobin
- Intravascular dyes |
|
|
Term
| ways to monitor Depth of anesthesia (5) |
|
Definition
1. CNS activity (EEG)
2. Muscle reaction (Jaw tone)
3. Response to stimuli
4. Sympathetic responses (HR, BP, RR)
5. Eye position / Activity |
|
|
Term
| What is the eye position of a surgical plane of anesthesia |
|
Definition
rotated ventral medial --> Looking at nose
Dull palpebral reflex |
|
|
Term
| How much blood can they lose before we get worried |
|
Definition
|
|
Term
| How much blood can one 4x4 swab hold? |
|
Definition
|
|
Term
| What 3 things does an Art BG tell us about |
|
Definition
1. Acid Base
2. Oxygenation
3. Ventilation |
|
|
Term
| What instrument tells you about % hemoglobin saturated by oxygen. but doesn't tell you if the patient is breathing |
|
Definition
|
|
Term
| Motion, Low Perfusion, Optical interference can all cause errors with what |
|
Definition
|
|
Term
| WHere should the eyes be looking when in surgical plane |
|
Definition
| Ventral Medial - Looking at their nose |
|
|
Term
| how much blood can be in one 4x4 gauze |
|
Definition
|
|
Term
| Do you need more or less anesthetic when patient is hyopthermic |
|
Definition
| LESS! Less metabolism/Breathing |
|
|
