IHS Intraoperative monitoring
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What is Standard V?
- 1. Deals with CRNA responsibility for pt monitoring.
- - Ex. CRNA must be in constant attendance until responsibility of care accepted by another
- - must doc all omissions of monitoring standard
- - Basis for all anesthesia care
Standard V states that CRNA must monitor
- A. Ventilation
- B. Oxygenation
- C. CV
- D. Temp
- E. NMB
- F. Positioning
Safe pt monitoring require one to
- avoid all distractions
- systematically redirect attention
- minimize turning back on surgical field
- minimize stress and fatigue
Monitors and VS must be placed before any drugs given?
- 1. T
- - Monitors are place first and removed last
What is the Beer-Lambert Law?
- Ratio of absorption of Red to infrared light in a pulsatile bed
- Red = 660 nm
- Infrared = 940nm
What is the Oxyhemaglobin curve?
Relates the percent of hemoglobin saturation with oxygen and the partial pressure of oxygen in the blood.
What are metabolic states that shift the curve to the right (Oxygen donating) and states that shift to the left (hemoglobin oxygen loving)?
- Left < 26 mmHg PaO2
- - Alkalosis
- - hypothermia
- - decrease 2,3 DPG
- Right > 26 mmHg PaO2
- - Acidosis
- - Hyperthermia
- - ^ 2,3 DPG
What is Carboxyhemoglobinemia?
What is Methemoglobinemia?
- 1. Occurs with carbonmonoxide poisoning - Lft shift
- 2. Occurs with there are ferric iron 3+ (Bad) vs ferrous iron 2+ (better). lft shift
At Red light wave frequency, reduced hemoglobin or oxyhemoglobin absorbs more light?
990 infrared is absorbed more by?
- - At 660 (red) is absorbed more by deoyxhemoglobin light.
- - Oxyhemoglobin
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