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Vigilance
| Vigilance: Keeping watch, being alertly watchful especially toward danger. |
| Monitoring of anesthetized patients is designed to collect data that reflect (1) physiologic homeostasis, allowing prompt recognition of adverse changes; (2) responses to therapeutic interventions; and (3) proper functioning of anesthetic equipment. Monitoring as such provides an early warning of adverse changes or trends before irreversible damage occurs. The most important monitor in the operating room is the vigilant anesthesiologist, who continuously obtains subjective and objective information from the anesthetized patient. Subjective monitoring depends on the anesthesiologist's senses (visual, tactile, auditory) and experience. This continual vigilance (awareness) on the part of the anesthesiologists is enhanced by the use of monitoring equipment designed to provide objective data relevant to the anesthetized patient's well being and the integrity of the anesthesia system. Human vigilance is not infallible, thus the importance of using monitors beyond the anesthesiologists' subjective observation. |
| The American Society of Anesthesiology has adopted standards for basic intraoperative monitoring. They encourage or mandate the use of pulse oximetry, capnography, an oxygen analyzer, a disconnect alarm, and a visual display of the electrocardiogram (BCG) in all patients undergoing anesthesia. additionally blood pressure and heart rate must be evaluated at least every 5 minutes. Depending on the patient's medical condition and the complexity of surgery, intraoperative monitoring may be expanded to include more technologically sophisticated and often invasive monitors. The inherent risk in the use of all monitors, especially invasive monitors, must be weighed against the potential benefits in selecting their use for individual patients. |
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