Anaesthetic monitors

RE: Anaesthetic monitors

Anthony Todd — Sat, 04 Sep 2021 15:15:34 GMT

[quote userid="11202" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29975/anaesthetic-monitors/232821#232821"]GPWS alert represents a failure for the crew and will lead to chat with Chief Pilot and possibly career advice. [/quote]

You'd better look at Air Crash etc. The alarm works when there is all sorts of major crises going on,including a crew incapacity etc. That is events that are very unusual, unexpected and critical for the flight, passengers and crew!

The chief pilot will probably say "thankyou Lord for an audible alarm!!

And vets with Apalert or similar used to really concentrate when the alarm went off, which, of course happens well before any closely observed screen value starts to change.

But if vets can't see that then good luck, I hope it doesn't happen when you're in charge!

The usual, IMHO, although rare, is a blocked/kinked./dislodged endo tube, respiratory movement but no O2, of course, and in the middle of some other drama can be missed if relying on respiration or a trace on a screen.

Been there, seen them all and the crew have saved the day more than once!

PS Ours used to be pretty well around as the last stitch went in? Not me, I was far too slow, they'd mostly gone to afternoon tea!!

I don't remember any trouble with the sensor??

RE: Anaesthetic monitors

Bob Russell — Fri, 03 Sep 2021 14:01:51 GMT

Pulse Ox may be useful for that trip from the operating table and through recovery. It may alert you that something is interfering with oxygenation. Something interfering with the airway for example.

We seemed to spend so much time fiddling with the sensor sometimes ending with a mini tantrum from the nurse or me! Relegated for recycling when the unit failed and not replaced. A good observant person watching recovery works well.

RE: Anaesthetic monitors

vetbl.locum — Fri, 03 Sep 2021 10:49:54 GMT

Apalert tells you nothing that a trained person is not able to observe Indeed may give false sense of security

Pulsoxy tells you something that a trained person is not able to observe but not particularly useful (Indeed may perhaps give false reassurance )

Capnograph tells you something that a trained person is not able to observe but IS particularly useful

GPWS alert represents a failure for the crew and will lead to chat with Chief Pilot and possibly career advice.

Rgds

RE: Anaesthetic monitors

Bob Russell — Fri, 03 Sep 2021 09:20:25 GMT

I should not bite but I will!

The pilot is there to use instruments to identify problems before there is a real danger of a crash. The audio alarms may come on when things start to go a bit out of line (as with a capnograph) and a pull up terrain warning when everything else has failed.

The Apalert is 40+ year old tech that provides little information other than the breathing pattern. It might look good to have a beeping machine but I found it provided far less information than the nurse could.

If you are going to use tech to help monitor anaesthetics then you really should be going for something that alerts to changes early.

My cockpit experience is limited to 'May Day/ Air Crash Investigation'!

RE: Anaesthetic monitors

Anthony Todd — Thu, 02 Sep 2021 16:34:49 GMT

None, just gliders.... And of course problems etc...I don't know why every aircraft seems to have all these unnecessary audio alarms?

Perhaps we should tell Boeing and Airbus??

RE: Anaesthetic monitors

vetbl.locum — Thu, 02 Sep 2021 15:55:51 GMT

Anthony how much flight time do you have as P1?

As with the capnograph, you want to pick up problems with aircraft BEFORE the Master warning goes off

Rgds

RE: Anaesthetic monitors

Anthony Todd — Thu, 02 Sep 2021 15:30:23 GMT

Sorry I was just referring to an audible alarm which has saved many an animal and aeroplane even with very highly trained and checked airline pilots

RE: Anaesthetic monitors

Bob Russell — Thu, 02 Sep 2021 15:25:00 GMT

Why? We have very good staff and good monitoring and none involves our Apalert which was relegated to a draw years ago which is where I believe it should be.

RE: Anaesthetic monitors

Anthony Todd — Thu, 02 Sep 2021 14:24:49 GMT

[quote userid="6550" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29975/anaesthetic-monitors/232799#232799"]Simple answer is yes. Our machine will alert us if theCO2 level goes over a certain level. Will alert us if the respiratory rate rate drops and has an apnoea warning. It will also tell us which anaesthetic agent is being used, the inspired and expired concentrations and the O2 levels (have to admit to not using that measure).[/quote]

Fine, thankyou, and some vets and staff will, sooner or later, be thankful too.

RE: Anaesthetic monitors

Bob Russell — Thu, 02 Sep 2021 13:58:56 GMT

Have you ever used anything other than an Apalert?

We aim to pick up problems before the patient stops breathing!

Simple answer is yes. Our machine will alert us if theCO2 level goes over a certain level. Will alert us if the respiratory rate rate drops and has an apnoea warning. It will also tell us which anaesthetic agent is being used, the inspired and expired concentrations and the O2 levels (have to admit to not using that measure).

As far as I am aware apnoea monitors are not used in human anaesthetics, again because you want to know something is amiss before the patient stops breathing.

Nothing beats a good member of staff and they should all be able to count the respiration and heart rates.

RE: Anaesthetic monitors

Anthony Todd — Thu, 02 Sep 2021 11:58:38 GMT

just to reassure me, 'cos I've made all the arguments, do all these recommended and/or used devices have an audible alarm??

No replies [I hope] means they all do??

RE: Anaesthetic monitors

Bob Russell — Thu, 02 Sep 2021 11:22:15 GMT

We routinely use an oesophageal stethoscope and an amplifier from JAK. Arnolds (who remembers them?) used to do a simple set up consisting of an amplifier and tie clip microphone that connected to an ET tube connector. About £30 from memory!

Our Apalert went into storage when we moved to capnography.

Our capnograph is part of our anaesthetic circuit and takes seconds to connect. I watch the trace from the corner of my eye.

None of this would be enough without a very competent person monitoring the anaesthetic!!

RE: Anaesthetic monitors

Clive Ansell — Thu, 02 Sep 2021 10:53:30 GMT

I was going to say the same thing.

a good nurse, stethocope, oesophageal stethoscope, thermometer is a good start.

For quick procedures and routine neuters in outwardly healthy animals, I think nothing else is required.

I often feel that hooking up and getting endless gadgets to work distracts a nurse from monitoring the patient properly, takes as long, or longer, than the procedure itself, increases anaesthetic time, and cannot see how it improves safety at all ?

RE: Anaesthetic monitors

Evelyn Barbour-Hill — Thu, 02 Sep 2021 10:00:29 GMT

The monitor is the nurse.

The devices are all monitoring aids.

The fundamental one I would not care to be without is cheap and effective: an oesophageal stethoscope and amplifier.