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Anesthesia Monitoring

Anesthesia means the medical condition of inducing sensation along with feelings of pain that is relieved for some time. It allows the patients to go through a surgery along with other procedures without pain and distress. Oliver Wendell Holmes created this word in 1846. Yet another definition for anesthesia is reversible lack of awareness. Anesthesia varies from analgesia in choking up all the sensation and not just pain.

Patients undergoing anesthesia normally go through preoperative evaluation including gathering the history of former anesthesia and various medical problems, ordering required blood group, consultations before surgery, and physical examination.

Patients treated under local anesthetics need to be monitored round the clock for ensuring complete safety.

For basic surgery, anesthesia management includes checking of the heart rates through pulse oximetry or Electrocardiogram or ECG, non-invasive blood pressure, expired and inspired gas for volatile agents, oxygen, nitrous oxide, carbon dioxide and oxygen saturation through pulse oximetry.

For moderate to major surgeries, anesthesia monitoring includes urine output, pulmonary artery pressure, and pulmonary artery occlusion pressure, neuromuscular function through peripheral nerve stimulation monitoring, temperature, cerebral activity through ECG analysis, cardiac output, and invasive blood measurements (central venous pressure, arterial blood pressure).

Moreover, the environment of an operation room needs anesthesia monitoring for humidity, buildup of exhaled inhalational anesthetics, and temperature, as it may impair the health of medical personnel in the operating room.

Anesthesia records are manually written on the paper. However, in recent times, electronic records have replaced the written paper records.

For moderate to major surgeries, anesthesia monitoring includes urine output, pulmonary artery pressure, and pulmonary artery occlusion pressure, neuromuscular function through peripheral nerve stimulation monitoring, temperature, cerebral activity through ECG analysis, cardiac output, and invasive blood measurements (central venous pressure, arterial blood pressure).

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What could cause ST elevation in Lead 2 (Lead II) on a 4 lead ECG but none in a 12 Lead ECG?

I'm a Paramedic and was monitoring a patients heart with a standard 4 lead monitor, Lead 2 showed about 4-5mm ST elevation and a deep R wave but when I connected 12 Lead cables to confirm Lead 2 was completely normal. After taking the 12 lead off the 4 Lead monitor still showed ST elevation. I'd given no medications other than oxygen. The cardiologist at the hospital was unsure how this happened any ideas?

If you're using the same electrodes, then there is clearly a problem with one of the machines or their wires. Try switching the wires around if that is possible. If not, or if there is no change, try hooking yourself up to the monitor and EKG. I suspect you will end up seeing the ST elevation on yourself also (i.e., it's an instrument artifact).

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