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10 Cards in this Set
- Front
- Back
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Goal of cardiac monitoring
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Assess the quality of myocardial
performance (SV) Preload Afterload Contractility |
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ECG monitoring does not guarantee what?
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contraction or perfusion
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ECG monitoring detects what?
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Conduction abnormalities
Problems with perfusion Pacemaker malfunctions Electrolyte disturbances |
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ECG-Lead Selection
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Get pre-induction strip****
Document ST – trending (note the leads) Leads II and V5 – gold standard – 95% of ischemic changes on 12 lead EKG can be picked up with these leads. Unipolar vs bipolar system Lead II P wave identification Inferior wall ischemia..ST depression Lead V5 Anterior and lateral wall ischemia Place at 5th intercostal space..left anterior axillary |
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BP Methods
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Take every 3-5 min**
Doppler obese and FHT’s Automated –Nerve palsies often with obesity it is easier to put in an art line |
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BP Methods #2
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Hand with highest cuff pressure
(if measuring both arms) |
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When do we use invasive BP/monitoring?
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Patient : Hemodynamically unstable, CAD, pulmonary disease, frequent ABG needed, hypothermic or hyperthermic,
Surgery: Chest surgery, Brain, CABG (no pulsatile flow) Anesthesia Technique: Low perfusion states |
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Central Venous Pressure Why place this?
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Venous access
Large fluid shifts Poor peripheral access Access for transvenous pacing Estimates preload - right side filling pressure (RVEDP) – or volume status |
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CVP monitor
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Measure to check for volume status
Place it in R atrium if looking for waveform Put in junction for monitoring Put in Right atrium for aspirating back for air embolism |
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TEE
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Based on principles of ultrasound
Can “see” heart volume and contractility status i.e. wall motion irregularities |
