《外科学总论》课件-3-anesthesia machine and monitors.ppt

Anesthesia Machine and Monitors Anesthesia machine Delivery of Medical Gases Oxygen N2O Air color coding VaporizerVolatile anesthetics are vaporized before being delivered to the patientNormal temperatureEnfluraneIsofluraneSevoflurane HalothaneAbnormal temperature Desflurane Breathing Systems: the circle systemA carbon dioxide absorber (contains soda lyme)Two one-way valves (inspiratory and expiratory)A Y-piece to connect to the patientA reservoir bagA pop-off valve that allows the release of excess gas when a certain pressure is achievedA ventilator Volume controlPressure controlParameter design PEEP Tidal volume  Pressure I:EVentilator Perioperative Monitoring AimEffective monitoring is a critical aspect of anesthesia care. The goal of patient monitoring is to provide optimal anesthetic management and detect abnormalities early in their course so that corrective measures can be instituted before serious or irreversible injury occurs. Although it is difficult to directly relate improved patient outcomes with specific monitors, the reduction in anesthesia-related morbidity and mortality has paralleled the institution of current monitoring practices. Routine Monitors Pulse oximetry Heart rate Measure blood oxygen saturation ??Blood pressure measurementAutomated device (inflated cuff)Invasive blood pressureElectrocardiographyHeart rhythm Heart rate Monitor of myocardial ischemia Routine Monitors Capnography End-tidal carbon Dioxide The wave form can give an idea of airway obstruction Ventilator pressure monitor Ventilator disconnection during general anesthesia Monitoring of airway pressure Temperature monitoring Specialized Monitors Monitoring of urine output (Foley catheter) ??Gross indicator of intravascular volume status and renal perfusion Arterial catheter ??Continuous measurement of arterial blood pressure ??Sampling of arterial blood Central venous catheter Continuous measurement of central ve