1.8 Monitoring techniques during anesthesia - clinical and technically dependant equipment

Lets begin with the Brain, move towards the mouth/lungs, then towards the core.

1. Brain

We can measure the brain activity by the bispectral index monitor. So,

Another parameter of importance is the train-of-four (TOF). It is meased by the device that sends a 2 Hz signal four times to measure the muscular tone.

2. Heart

We can measure the heart rate, the blood pressure and even perform real-time ecgs to monitor the cardiovascular system. The important leads for ischemia are leads II and V5.

3. Lungs

The respiratory system can be monitored by breathing rate, capnography that can measure inhaled and exhaled partial pressures of gases, pulse oximetry, oxygen saturation in the blood. An important parameter to control is FiO2 which is the fraction of inspired oxygen. It should be around 30% to 40% in the gaseous mixture that is being respired by the patient.

4. Temperature

The body temperature can be measured at some specific sites. At the nasopharynx (for upper body temperature checking), esophagus (for middle or core) and rectum or bladder (for lower body temperature monitoring). In the rectum the measured temperature is a little higher. In the armpit, the measured temperature is a little lower.

Lastly, clinical and technical equipment. The above techniques rely on technical equipment. Clinical monitoring is:

1. seeing for example seeing the lights and figures on the monitors and even seeing the patient (e.g. their chest rising and their skin color for example).
2. hearing for example the beeps of the monitors and the alarms and even ascultation.

Both of these techniques clinical and technical are complementary to each other and the hosptial staff can interpret these sources of information to make informed decisions.