AANA journal
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A young woman who sustained severe head trauma presented to the operating room for emergent surgical intervention. Her electrocardiogram (ECG) exhibited signs of myocardial ischemia, which resolved several days postoperatively. ECG changes suggestive of cardiac pathology can be associated with intracranial pathology, most notably subarachnoid hemorrhage. ⋯ Continuous ECG monitoring is essential. Ventricular dysrhythmias may prove resistant to conventional pharmaceutical management. Beta blockade may be indicated to prevent excessive cardiac stimulation by endogenous catecholamines, and, in addition, may prevent the formation of the microscopic cardiac lesions typical of this hyperstimulation.
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A new anesthesia technology, Side Stream Spirometry, now allows clinicians to monitor pressure, volume, flow, compliance, and resistance during routine anesthesia practice. Continuous monitoring with Side Stream Spirometry is a major adjunct to patient safety because numerical and visual references show how change in one respiratory parameter affects the mechanics of the entire breath cycle. To optimize ventilation and ensure adequate oxygenation, it is common practice for clinicians to verify that the proper volume per breath is being delivered to the patient at the lowest possible pressure. ⋯ This sensor location provides actual patient information which is not altered by the volume of gas compressed in the breathing circuit, the absorber system, or in the bellows of the ventilator. This installment of the AANA Journal Course will discuss the technology of Side Stream Spirometry and its application to monitoring pulmonary ventilation. Clinical evidence of ventilatory changes will be graphically demonstrated using the CAPNOMAC ULTIMA, a respiratory gas monitoring system, equipped with Side Stream Spirometry.