Perianaesthesia Monitoring

ANAESTHESIA MONITORING

Basic anaesthesia monitoring involves

• Non-invasive blood pressure [NIBP] using a 5min cycle

• Pulse oximetry (continuous)

• 3 lead ECG (continuous)

• Capnography (continuous)

• Entropy or Bispectral [BIS] (continuous awareness monitoring)

All patients receiving general anaesthesia will have this monitoring applied. Those undergoing major regional anaesthesia without general anaesthesia, local &/or sedation may not require capnography however most anaesthetists will prefer NIBP, SpO2 & ECG be monitored.

Advanced monitoring techniques will only be required for critically ill patients or those undergoing more complex procedures such as cardiothoracics, neurosurgery, spinal, major vascular or major head & neck.

Invasive monitoring will be utilised for these patients & includes

• Arterial lines

• Central venous lines or PICC lines

• Nerve Integrity Monitoring [NIM]

• Swan Ganz Catheters

Anaesthetists MUST insert these lines

You may have heard of nurses engaged in the insertion of invasive lines, namely, central lines, in critical care areas. These are highly trained individuals usually at the level of a nurse practitioner. You can read more about this advanced practice here

PACU MONITORING

Basic monitoring applied to PACU patients who have undergone sedation, regional or general anaesthesia includes

• NIBP cycled every 5min

• Pulse oximetry (continuous)

• Temperature (usually every 15mins)

3 lead ECG has been appearing in the literature in recent years as a discussion topic to add to the basic monitoring requirements in PACU. ECG can identify impending complications swiftly & assist with effectively assessing & treating those complications in a timely manner.

Does you facility implement mandatory 3 lead ECG for your PACU patients?

Please always refer to your organisational policy in regards to monitoring frequency requirements.

Some helpful resources you may find useful include

https://www.capnography.com/[excellent resource to learn all things capnography, even in areas outside of the perioperative suite]

https://www.perioperativecpd.com/anaesthetics/[Perioperative CPD – a free online resource designed for the UK however most is transferable to an international audience]

If you would like to take a deeper dive into all things perianaesthesia, be sure to head over to www.thrivingedu.com to join our mailing list to find out when our exciting online fundamentals of perianaesthesia nursing course opens up