Monitoring During Endoscopy

anaesthesia monitoring safety sedation Nov 11, 2024

Keep your finger on the pulse - monitoring for endoscopy πŸ©ΊπŸ’‘

Clinical observation and monitoring is the backbone of safe patient care during anaesthesia, forming a standardised practice that can be tailored to suit the individual needs of the patient and procedural requirements. πŸ§‘‍βš•οΈπŸ‘©‍βš•οΈ

At a minimum, all patients undergoing general anaesthesia or sedation should have the following monitoring applied:

🌑️ Pulse oximetry  - when in use, the variable pulse tone and low threshold alarm should be set to a volume audible to the practitioner responsible for anaesthesia. πŸ”Š

πŸ’“ Intermittent non-invasive blood pressure  - the interval of measurement will be variable between patients depending on their condition, but at a minimum should cycle no less than every 10 minutes. ⏱️

πŸ“ˆ Electrocardiograph (ECG) - should be available for every anaesthetised patient. It should also be used for every patient undergoing regional anaesthesia.

For patients undergoing general anaesthesia, additional monitoring including oxygen analysis πŸ₯, end tidal Carbon dioxide (etCO2) 🌬️ and inhalational anaesthetic agent monitoring (where applicable) should be in use.

For patients receiving sedation, etCO2 monitoring should be immediately available for use for every patient.

All patients receiving sedation should have oxygen therapy πŸ’¨ applied at its commencement, with close ongoing observation πŸ‘€. Oxygen therapy helps to prevent hypoxia, however, it can mask hypoventilation, so patients receiving deep sedation or who are deemed to be high risk ⚠️ should have etCO2 continuous waveform monitoring applied as well.

In the endoscopy suite πŸ₯, most patients are receiving sedation to facilitate their procedure, with variable and rapidly changing levels of sedation encountered. Regular communication πŸ—£οΈ with these patients is essential to gauge their level of sedation and provide them with reassurance. 🀝

It is important to note that once verbal communication with a patient is lost, the patient then requires the same level of care and monitoring as for general anaesthesia. 🚨

Monitoring forms part of the overall patient assessment πŸ“, bearing in mind it is subject to error and malfunction ⚠️, and does not replace the most important pieces of monitoring you have - your eyes πŸ‘€ and critical thinking! πŸ€”

βœ… Build Knowledge
βœ… Improve Safety

 

References:

ANZCA PS18 (2017) Anaesthesia Monitoring. https://www.anzca.edu.au/getattachment/0c2d9717-fa82-4507-a3d6-3533d8fa844d/PS18-Guideline-on-monitoring-during-anaesthesia

Blayney, M.R. (2012) Procedural sedation for adult patients: an overview. Continuing Education in Anaesthesia Critical Care & Pain, Vol. 12(4) Pp 176–180, https://doi.org/10.1093/bjaceaccp/mks016

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