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Basic Patient Monitoring For Anesthesia Blood Pressure

Basic Patient Monitoring For Anesthesia Blood Pressure. Dr. Jeffrey Elliot Field HBSc , D.D.S. , Diplomat of the National dental Board of Anesthesia, Fellow of The American Dental Society of Anesthesia. Non-invasive blood pressure monitoring [i.e. NIBP monitors], a re t hey a ccurate?.

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Basic Patient Monitoring For Anesthesia Blood Pressure

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  1. Basic Patient Monitoring For AnesthesiaBlood Pressure Dr. Jeffrey Elliot Field HBSc, D.D.S. , Diplomat of the National dental Board of Anesthesia, Fellow of The American Dental Society of Anesthesia

  2. Non-invasive blood pressure monitoring [i.e. NIBP monitors], are they accurate? • NIBP blood pressure determination values will vary by as much as 37 mm Hg from the direct arterial values. • This large discrepancy indicates that treatment should never be made based on a single NIBP determination without comparison to an auscultatory blood pressure determination or several consecutive measurements performed by an NIBP monitor.

  3. Correct Cuff size ,is it important? • Cuff width = 40% of arm circumference in order to obtain a proper reading. • American Heart Association recommended sizes for blood pressure cuffs based on arm circumference. • Extremity circumference* (cm) Cuff name • 5 - 7.5 Newborn • 7.5 – 13 Infant • 13 – 20 Child • 17 – 25 Small adult • 24 – 32 Adult • 32 – 42 Large Adult • 42 – 50 Thigh

  4. Pitfalls of poor cuff size selection. • Using a cuff that is too small will lead to falsely high readings. • Using a cuff that is too large will lead to falsely low readings.

  5. Factors that will interfere with proper functioning of the NIBP device. • Several circumstances can prevent accurate determination of blood pressure with NIBP devices. • Highly irregular or rapid cardiac rhythms. • Excessive patient movement such as shivering, restlessness, or external movement such as that from a helicopter, ambulance transport, or a rapid cycling ventilator can interfere with detection of cardiac oscillations by the NIBP monitor.

  6. Desirable blood pressure is the blood pressure at which no adverse health effects are noted. So what are the adverse health effects associated with hypertension? • Adverse health effects associated with high blood pressure are stroke, heart attack, kidney failure or heart failure .

  7. So what is the desirable blood pressure range.

  8. Intraoperatively what changes in blood pressure are acceptable? • The generally acceptable blood pressure fluctuation under sedation or general anesthesia is: + or -20% of the baseline.

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