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)

 

 

Feedback welcome at ketaminenightmares@gmail.com