Follow-up question Dr. Berg
January 27, 2015 | 20,00 EUR | answered by Dr. med. Ralf Berg
Dear Dr. Berg,
I am back with new concerns. This time, it is about terms from an anesthesia monitor. Last time, you provided me with very valuable tips.
1. Pbaro 746 mmHg
What does Pbaro mean in relation to anesthesia? Is Pbaro always determined during anesthesia, or only in emergencies? Does it mean that I had a Pbaro of 746 mmHg during my anesthesia, or is it a setting that was programmed into the anesthesia monitor?
2. In my monitor values, there is also an FIO2 that was determined twice.
FIO2 (m) 23%
FIO2 (s) 100%
What is the difference between the two? I thought oxygen can only be administered once, either at 23% or 100%?
3. AWP peak (s) 40 cm H2O
Can you briefly explain what this is about?
And the last and most important question, what does the small (s) in parentheses always mean? (besides FIO2 and AWP Peak)
Thank you in advance!
Dear questioner,
I have already answered this question twice. Unfortunately, my answer seems to not have been transmitted.
So once again, in short: pbaro746mm hg = the air pressure on the day of your procedure was P = pressure baro = barometric measured in mm HG height of a mercury column in mm (7467)
This information has nothing to do with you. It can be entered or measured in order to more accurately dose the anesthetic gases. Gases are compressible, so with the same valve setting, a higher air pressure will result in fewer gas molecules being mixed in, such as with the addition of anesthetic gases at a lower air pressure.
This is especially relevant when working with techniques such as Low Flow or Minimal Flow. Low Flow = up to 1 liter gas consumption, Minimal Flow = less than 1 liter gas consumption.
Fi02 23% is the percentage of oxygen content in a gas mixture. Inhaled air FI = inspiratory concentration of 02 = oxygen. The oxygen content in room air is 20%, 23% (3% additional) is a common default setting. The Fi02 is continuously determined on every anesthesia machine. This is required for vital reasons. This value is continuously displayed on the anesthesia machine. These two values are just two documented values. The last one means that the oxygen valve was fully open and pure oxygen was administered. If this is documented at the end of the anesthesia, it is a common procedure to wash out the anesthesia gas faster. This setting can also be used to counteract hypoxia in the blood.
3. aw = Airway P Pressure Peak = Peak 40cm h20 water pressure of 40 cm height
Specifies the maximum peak pressure in the airways up to which a ventilator may build up pressure. If this is exceeded (e.g. because the patient coughs, breathes against it, or the surgeon leans on the chest), the remaining volume is released via a pressure relief valve so that the airways do not suffer pressure damage.
PS: I also do not know everything: s or m in parentheses? Perhaps a hint as to who initiated the protocol entry? s = Security Alarm m = manual entry?
The only help is the manual of the anesthesia machine where this is explained. It is possible to configure what is automatically logged.
PS: Do you only have a monitor printout, or do you have the complete anesthesia protocol? With the signature of the anesthesiologist? The important things are entered there. Comments and remarks cannot be recorded by even the best monitoring system.
With many greetings until next time. R. Berg
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