PS18 2017: Monitoring during anaesthesia

List:

· Summary

· General comments

· Sedation

· Major regional

· General anaesthesia

Summary:

	Sat probe	BP cuff	ECG	Capno
Sedation	+	+
Regional	+	+	+
General	+	+	+	+

(N.B. proper ventilator is also required for general anaesthesia)

General comments:

· Monitors do not replace vigilance and situational awareness

· Anaesthetist must be present from start to finish

· Brief absence ok so long as a competent assistant is present

· Permanent handover can only be to another anaesthetist

· Alarms must be enabled and noisy

· Data must be documented

Sedation:

Respiratory	· Ventilation: observation · Oxgenation: SpO2
Cardiovascular	· HR (i.e. SpO2) · NIBP (omission must be justified) · Intervals ≤ 10 minutes
Must be available	· ECG · Capno

Major regional:

· PS18 (this document) says NIBP + ECG

· PS03 (regional document) says NIBP + RR + conscious state, with SpO2 and ECG available

General anaesthesia:

Respiratory	· SpO2 · Ventilator: alarms for pressure, disconnection, failure to ventilate · Gas analysis: O2, CO2, inhaled anaesthetic
Cardiovascular	· HR (from ECG or SpO2) · NIBP (omission must be justified - e.g. brief paeds case) · ECG · Intervals ≤ 10 minutes
Must be available	· ABP · Temp (if active warming) · NMT (if paralysed and planning extubation) · Processed EEG (if high risk of awareness)

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