Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Patient monitoring in and out of theatres[Appraised by Dr Liz Summ, January 2009]Miscellaneous issuesPatient monitoring must conform to Association of Anaesthetistsstandards – both clinical and instrumental. The monitoring usedshould include ECG, pulse oximetry, non-invasive blood pressure,inspired oxygen and gas analysis. In the event of intubation beingnecessary, capnography must be used. In prolonged surgery,temperature should be monitored.A few years ago anaesthetists were occasionally faced withdilemmas about conducting patient care when the required standardof monitoring was not available. The facilities and equipment are soimproved today that there should be no reason to accept lowstandards.However: if monitoring equipment in the anaesthetic room isinsufficient, then either:• Induction must take place in the theatre, or• Full monitoring equipment must be brought to the patient on atrolley.In the event of capnography or capnometry being unavailable wherea patient requires intubation, you must inform the general consultanton call.Monitoring patients from theatre to recoveryA high standard of monitoring should be maintained until the patientis fully recovered from anaesthesia. If the recovery area is notimmediately adjacent to the operating theatre, or if the patient'sgeneral condition is poor, adequate mobile monitoring will be neededduring transfer (pulse oximetry and NIBP as a minimum). This isavailable within the theatre suite using the Dash monitors. These canbe removed from the docking station in theatre and swapped with theone in the recovery or PACU bay to which the patient is transferred.Anaesthetists Handbook January 2010 221