Monitoring in Anesthesia幻灯片.pptVIP

Monitoring in Anesthesia ??.????????? ????????????? ?.?., ?. ???????????????????????, ??.(???????) ??????????????????? ??????????????????????????????? ????????????? Topic module 1.????????????????????????????????????????? 2.????????????????????????????????????????????????? 3.????????????????????????????????????????????? ( NIBP , SpO2 , ECG , ET-CO2 ) Contents Introduction What is monitoring? Which, Why and How to monitor? Level of monitoring Standards for basic intraoperative monitoring ( ASA) Systematic monitoring Conclusion Monitoring: A Definition ... interpret available clinical data to help recognize present or future mishaps or unfavorable system conditions ... not restricted to anesthesia (change “clinical data” above to “system data” to apply to aircraft and nuclear power plants) What is monitoring? to monere (????????????, ???????????) Physiologic parameter Patient safety parameter Clinical skills Monitoring equipment Data collection, interpretation, evaluation, decision Problem seeking, Severity assessment, Therapeutic assessment, Evaluation of Anesthetic interventions Patient Monitoring and Management Involves … Things you measure (physiological measurement, such as BP or HR) Things you observe (e.g. observation of pupils) Planning to avoid trouble (e.g. planning induction of anesthesia or planning extubation) Inferring diagnoses (e.g. unilateral air entry may mean endobronchial intubation) Planning to get out of trouble (e.g. differential diagnosis and response algorithm formulation) Level of monitoring Routine / Specialize / Extensive Non-equipment / Non-invasive / Minimally invasive / Penetrating / Invasive / Highly invasive Systematic Respiratory / Cardiovascular / Temperature/Fetal Neurological / Neuro-muscular / Volume status Renal Standards for basic intraoperative monitoring ( ASA) Standards for basic intraoperative monitoring ( ASA : American Society of Anesthesiologists) Standard I Qua