Anesthesia - induction/ emergence question

[Apollonia]

Hi,

new OR nurse just started who needs help.

when you're by the patient who is being intubated what are you monitoring for? Do you look at the patient? The anasthetic machine? When you look at the machine, what do you monitor, the 02 sats, pulse, bp? the ECG? What about emergence? Do you look at the gases and whether they're all gone? vitals or the patient? I'm not sure what exactly I should be looking at.

Also, is there a website that points out to what all the things on the anasthetic machine monitors are ?

please and thank you :)

[MamaCheese]

I leave the monitoring the the CRNA. During induction I stand by to give them a hand for cricoid pressure, pulling the stylette, holding the tube while they tape it, etc.. During emergence I'm there to make sure the patient doesn't try to jump off the table when they wake up. I don't pay much mind to their monitors unless they start alarming.

[fracturenurse]

I'm with MamaCheese, I leave the monitoring to the CRNA or anesthesia doc. The only thing I do look for is if I'm giving cricoid pressure is the "mountains" that start showing up on the bottom of the monitor showing they have CO2. Of course I still don't let go until they give me the OK. During the case if I hear the alarms go off an see a lot of activity up at the head of the bed, I do go up to make sure everything is OK and see if they need anything.

[shodobe]

I agree with others. Listening for the sat levels dropping indicates there might be a problem. I do watch the vitals up on the monitor just so I know what is going on. Be ready to help anesthesia, cricoid, stylet, etc.................

[KayceeCA]

I agree with everyone else...I listen to the sat level beep, but I don't do anything without direction from the anesthesia provider. I stand by ready to apply cricoid pressure, hand the ET tube, and lend a hand in any other way I can. But I leave the monitoring to anesthesia.

[mcmike55]

The previous posters know their stuff alright!!! And we all are on the same page here!

When helping with induction, I'm there to pull the stylet, maybe move the cheek out of the way, etc.

In a crash induction, or rapid seqence, there's a bit more. In case you don't know, this is done when you have someone that's not NPO, or has a significant history of GI issues, such as GERD, and may vomit during induction.

In this case, I'm holding cricoid pressure with one hand and assisting with the other.

In the mean time, I'm also listening to the pulse ox, which will tell me rate, and basic oxygen level by the tone.

One key in my mind with cricoid pressure......do not let go until the anes. provider tells you to. Even if you (or the surgeon) thinks the tube is in the right place. It may not be!!!!

Wait for the balloon to be inflated and the anes. provider to say, OK, you can let go. Until then,,,it's not over!!!

I'm proud to say, I helped save one pt from aspiration this way. On a trauma victim, the pt vomited during induction, filled the anes mask for a second before we could suction them out. Checked the cords, etc later....and nothing got past me!!

It can be done! Hope that helps.

Mike

[Apollonia]

Thanks for everyone to your responses. This makes helping the anesthetist much more clearer. I thought I had to be focusing on the monitors and everything along with being that third hand for then. Thank you.

[CRNAGAL]

Mike, cricoid pressure is a means of reducing risk of aspiration due to stomach contents refluxing out of the esophagus, not keeping them from going down to the cords. If the pt. vomited into the mask, cricoid pressure did not work.