Respiratory/ventilatory monitoring (Proceedings)

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Respiratory/ventilatory monitoring (Proceedings)

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Nov 01, 2010

ACVA Current Recommendations

          • Circulation
          • Ventilation
          • Oxygenation
          • Central Nervous System
          • Fluid Therapy
          • Temperature
          • Neuromuscular Blockade
          • Record Keeping
          • Personnel
          • Recovery
          • Temperature

     • AAHA requirements
     • At least one of these monitors on all sedated or anesthetized patents (incl – dentals, rads)
          • Electronic respiratory Monitor
          • Pulse Oximeter
          • Blood Pressure Monitor
          • Continuous ECG
          • Esophageal Stethoscope
          • Capnograph

Ventilation = exchange of oxygen and carbon dioxide through inhalation and exhalation
Hyperventilation = ventilation that exceeds metabolic demands
Hypoventilation = ventilation that does not meet metabolic demands

Visualization

     • Simplest method of monitoring the respiratory system
     • Visualization of the chest wall excursion or breathing bag movement can suggest ventilation

Respiratory Cycle

     • Inhalation - Diaphragm contracts
               • Lungs expand
               • Alveoli open
               • Vacuum created
                         • Air is drawn into lungs
               • Abdominal organs displaced caudally
               • Coordinated outward movement
               • Diffusion
                         • Capillary-alveolar membrane
                              • Oxyhemoglobin
          • Exhalation - Diaphragm relaxes
                  • Thoracic cavity size decreases
                  • Air expelled from lungs
                  • Coordinated inward movement
                  • Carbon dioxide is exchanged at the alveolar level and exhaled

Increased Inspiratory effort may be indicative of:
               • Upper airway
               • Laryngeal paralysis
               • Collapsing trachea
               • Increased expiratory effort
               • Lower airway
               • Asthma
               • COPD