1 / 16

B is for Breathing

B is for Breathing. Irene Bouras Anaesthetic SpR UCLH. Pre-Operative Considerations. Assessment of respiratory function History Examination Investigations Functional assessment is the most important. Pre-Operative Considerations. Assessment of respiratory function History Examination

nowles
Download Presentation

B is for Breathing

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. B is for Breathing Irene Bouras Anaesthetic SpR UCLH

  2. Pre-Operative Considerations • Assessment of respiratory function • History • Examination • Investigations • Functional assessment is the most important

  3. Pre-Operative Considerations • Assessment of respiratory function • History • Examination • Investigations • Functional assessment is the most important • Will they be difficult to ventilate? • What are your options?

  4. Optimising Respiratory Function

  5. Intra-operative • Pre-operative monitoring & IV access • ?Pre-oxygenation • Induction of anaesthesia

  6. Intra-operative • Pre-operative monitoring & IV access • ?Pre-oxygenation • Induction of anaesthesia Apnoea Airway obstruction Take over ventilation & secure airway

  7. Intra-operative Ventilation Spontaneous IPPV Prevent atelectasis Can control ETCO2 BUT Can cause barotrauma & volutrauma Higher risk of awareness • Don’t need to stop & start breathing • RR good guide to degree of pain BUT • Prone to hypoventilation

  8. Monitoring Ventilation Patient Parameters

  9. Monitoring Ventilation Ventilator Parameters

  10. Monitoring Oxygen Saturations • Monitors oxygenation not ventilation End-Tidal CO2 • Measures adequacy of ventilation • Confirms circuit is intact & that patient has CO

  11. Frequency 10-12/min • FiO2 Tidal Volume 8-10mls/kg

  12. Post- Operative • Respiratory compromise may be caused by many factors • Patient factors: pre-existing lung disease • Anaesthetic factors: high epidural, high dose opiates • Surgical factors: diaphragmatic splinting • May need to keep some patients intubated on ICU post-op

  13. Summary • A good pre-operative assessment is essential • Get respiratory function as good as possible pre-op • If you’re worried about ventilation intra-operatively the monitors should give you an idea where the problem lies

More Related