rad 104 hospital practice and care of patients 5 anesthesia 2016

Hospital Practice &

Care of Patient

RAD 104

Anesthesia

Anesthesia

• From Greek anaisthesis means ”not sensation”• Listed in Bailey´s English Dictionary 1721.• When the effect of ether was discovered

”anesthesia” used as a name for the new phenomenon.

Basic Principles of Anesthesia

• Anesthesia defined as No Sensation

• Analgesia defined as No Pain

History of Anesthesia

Anesthesiologists

Anesthesiologists care for the surgical patient in the

• preoperative, • intraoperative, and • postoperative period .

Patient Safety

• Patient risk and safety are concerns during surgery and anesthesia .

• Data from a number of studies of death caused by anesthesia indicate a death rate ranging from 1 per 20,000-35,000.

Preoperative preparation patient evaluation

• Anaesthesiologist:• reviews the patient´s chart,

– evaluate the laboratory data and diagnostic studies such as electrocardiogram and chest x-ray,

– verify the surgical procedure, – examins the patient, – discuss the options for anesthesia and the

attendant risks and – ordered premedication if appropriate

Types of anesthesia careGeneral Anesthesia

• Reversible, unconscious state is characterised by amnesia (sleep, hypnosis or basal narcosis), analgesia (freedom from pain) depression of reflexes, muscle relaxation

• Put to sleep

Types of anesthesia careRegional Anesthesia

• A local anesthetic is injected to block or ansthetize a nerve or nerve fibers

• Implies a major nerve block administered by an anesthesiologist (such as spinal, epidural, caudal, or major peripheral block)

Types of anesthesia caremonitered anesthesia care

• Infiltration of the surgical site with a local anesthesia is performed by the surgeon

• The anasthesiologist may supplement the local anesthesia with intravenous drugs that provide systemic analgesia and sedation and depress the response of the patient´s autonomic nervous system

Types of anesthesia carelocal anesthesia

• Employed for minor procedures in which the surgical site is infiltrated with a local anesthetic such as lidocaine or bupivacaine

• A perioperative nurse usually monitors the patient´s vital signs

• May inject intravenous sedatives or analgesic drugs

Conscious Sedation

• Used for short, minor procedures

• Used in the O.R. and outlying areas – (ER, GI Lab, Radiology , etc)

• Patient is monitored by a nurse and receives sedation sufficient to cause a depressed level of consciousness, but not enough to interfere with patient’s ability to maintain their airway

The Awake Patient• Patients undergoing surgery with regional or local

anesthesia, even if sedated, may be aware of conversation and activity in room

• Limit any discussion of patient’s medical condition and prognosis

• Avoid discussion of other patients & limit unnecessary conversation-- a sedated patient can easily misinterpret conversation they overhear

Ways of giving anesthesiaLocal anesthesia:• Localized temporary loss of sensation :• - Injection (Subcutaneous, subdermal)• - Spray. • - Drops.

General anesthesia• total loss of sensation (unconsciousness):• - Orally• - Intravenous Injection.• - Rectally• - Inhalation

Ways of giving anesthesia

Local anesthesia:• Localized temporary loss of sensation :• - Intravenous Injection. • - Spray. • - Drops.

General anesthesia• total loss of sensation (unconsciousness):• - Orally• - Intravenous Injection.• - Rectally• - Inhalation

Preparation and patient care during and after anesthesia:

• 1. Greet the patient by name and give him/her some words of comfort and reassurance.

• 2. Check carefully the patient's identity.• 3. Check that the patient has been

prepared.• 4. Make the patient as comfortable as

possible.• 5. be quiet, don’t laugh don’t whistle,

don’t sing.• 6. If the patient wishes to talk, reply

gently, briefly and reassuringly.• 7. One person at least must always

remain with the patient inside the room, never leave him/her alone

Preparation and patient care during and after anesthesia:

• 1. Greet the patient by name and give him/her some words of comfort and reassurance.

• 2. Check carefully the patient's identity.• 3. Check that the patient has been prepared.• 4. Make the patient as comfortable as possible.• 5. be quiet, don’t laugh don’t whistle, don’t

sing.• 6. If the patient wishes to talk, reply gently,

briefly and reassuringly.• 7. One person at least must always remain

with the patient inside the room, never leave him/her alone

Radiographer's duties during and after anesthesia

During Anesthesia:- Assist with any intravenous injection.

- Handle to the anesthetist any instruments, drugs or apparatus needed.

- Under anesthetist direction, adjust the flow of a transfusion , oxygen, or check the pulse or blood pressure of the patient.

Radiographer's duties during and after anesthesia

After Anesthesia:1. Never leave the patient alone.

2. Keep the airway patent by placing

the patient in left semi-prone or in supine position and turn the head to one side.

3. Record pulse, respiration and blood pressure.

4. Note any change in the patient's condition e.g. pallor, Cyanosis, respiratory difficulty and reports such-changes immediately to -the doctor.

5. Guard patient from injury.

6. N.P.O. (Nil Pass Orally) until patient becomes fully consciousness.

Radiographer's duties during and after anesthesia

During Anesthesia:- Assist with any intravenous injection.

- Handle to the anesthetist any instruments, drugs or apparatus needed.

- Under anesthetist direction, adjust the flow of a transfusion , oxygen, or check the pulse or blood pressure of the patient.

After Anesthesia:1. Never leave the patient alone.

2. Keep the airway patent by placing

the patient in left semi-prone or in supine position and turn the head to one side.

3. Record pulse, respiration and blood pressure.

4. Note any change in the patient's condition e.g. pallor, Cyanosis, respiratory difficulty and reports such-changes immediately to -the doctor.

5. Guard patient from injury.

6. N.P.O. (Nil Pass Orally) until patient becomes fully consciousness.