Principles of Anesthesia: Patient Identification Marking Shifting To OT

PRINCIPLES OF ANESTHESIA
Patient Identification
Marking
Shifting to OT
Grace Paul
191124006
BAOTT
ANESTHESIA
Complete loss of sensation with or without
consciousness as a result of administration of
anaesthetic agents, usually by injection or
inhalation.
The medication used to block pain are called

anaesthetics.
Anaesthesia temporarily block sensory or pain

signals from nerves to the centres in the brain.
Administration of Anaesthetics
Depending on the procedure and type of

anaesthesia needed,anaesthesia delivered via
• Inhaled gases
• Injection or Intravenous(IV)
• Topical(applied to skin or eyes)liquid,spray or
patch
TYPES OF ANESTHESIA
 Local Anesthesia
 Regional Anesthesia *Spinal Anesthesia
*Epidural Anesthesia
 General Anesthesia
 Local anaesthesia given to temporarily stop the

sense of pain in particular area of the body
Remains conscious during a LA
In dentistry, for eye surgeries cataract removal,
to remove small skin growth including moles.
 Regional anaesthetics affects larger areas such
as arm, a leg or everything below the waist.
Anaesthesia used in joint surgeries and hand, to
ease the pain of child birth or during a C section
delivery
 GA affects the whole body,making patient

unconscious and unable to move.
o To operate internal organs
o For invasive or time consuming surgeries
o Major life saving procedures open heart surgery,
brain surgery and organ transplants
Anaesthetic state(GA) consisting of a triad of
SLEEP,ANALGESIA and MUSCLE RELAXATION
Preparation of GA
Before giving anesthesia, considerations should
be given to the induction of anesthesia, the
position of the patient on the operating table,
monitoring, use of intravenous fluids or blood
transfusion,postoperative care and recovery
facilities required.
Preparation of GA Conti..
 Preoperative Evaluation
 History and Physical examination
 Airway
 American Society of Anesthesiologist(ASA) Classification
 Preoperative Fasting
 Preoperative Medications
History and Physical Examination

 Obesity,Steroid use,OSA,Congenital anomalies
 Prior surgery
 Prior anesthetics and anesthetics record
 Family history of hyperthermia
Stages of GA
 1.Premedication
2.Monitors
3.Oxygen
4.IV access
 Induction –Awake patient to anesthetized one
• Amnesia or Analgesia
• Delirium or Excitement
• Surgical Anesthesia – eg IV propofol or inhalation
Rapid and minimally unpleasant
Loss of airway protection-must ventilate the
pt
 Intubation- secure ET tube
 Maintenance eg Sevoflurane
 Monitoring
 Emergence- communication
Induction of GA
Inhalational Induction
Use of inhalational anesthetics- halothane,
sevoflurane,isoflurane,enflurane,desflurane etc.
If sponataneous ventilation is to be maintained

throughout the procedure, the mask is applied and
as consciousness is lost the airway can be
supported by guedal airway or laryngeal mask or
by ET tube
Indications for Inhalational induction
Young children
Upper airway obstruction
Lower airway obstruction with foreign body
Bronchopleural fistula
Difficulties and Complications

Slow induction of anesthesia
Airway obstruction
Laryngeal spasm, bronchospasm
Environmental pollution
Intravenous Induction
Monitoring should be started on the patient

including SpO2,Blood pressure,ECG,Temperature.
Preoxygenation should be started using facemask

with delivering 100% oxygen
Induction can be done by IV induction agents

Thiopentone,Etomidate,Propofol,Ketamine
Complications of IV Induction
Regurgitation and vomiting

Intra arterial injection
Perivenous injection
Cardiovascular depression
Respiratory depression
Histamine release
Pain on injection
Positioning
Position appropriate for the proposed surgery
Should take into account surgical access, patient

safety, anesthetic technique, monitoring and
position of iv lines
Commonly used positions
Lithotomy position may result in nerve damage
Lateral position may cause asymmetrical lung
ventilation
Prone position may cause abdominal compresion
Trendelenburg position cause pressure on diaphragm
Sitting position need good support of head
Supine position may cause supine hypotensive syndrome
during pregnancy
Maintenance of GA
Maintenance means continuation of anesthesia
The overall goal of maintenance phase of GA are

to maintain stageIII Surgical anesthesia
(unconsciousness,amnesia,immobility,unresponsive
to surgical stimuli)at a safe anesthetic depth
while maintaining respiratory and hemodynamic
stability
Relaxation for surgery achieved by non
depolarising muscle relaxant
Reversal
Reversal of anesthetic effect indicated when
the anesthetic effect no longer required or
patient sensitive to anesthetic and effect needs
to be reduced or reversed.
At the end of the surgery the muscle

blockade effect of non depolarizers reversed by
neostigmine+glycopyrrulate
Then patient is extubated after thorough

suctioning of oral cavity
Patient Identification
The patient should have atleast two patient identifiers as evidence
to confirm identity
It decreases the chance of performing wrong procedure on the
wrong patient
Examples of acceptable patient identifiers
include,
 Name
 Assigned identification number
 Telephone number
 Date of birth
 Social security number
 Address
 Photograph
Patients room no should not be used as a identification marker
Identification Marker
All patients undergoing surgical procedure should

wear a marker
1. Identification markers on patient will prevent
wrong patient surgery
2. Will prevent wrong procedure and wrong site
surgery
3. Identification markers can include the following
Wrist band as identification bracelet
Wrist band with unique bar coded patient identifier
Radio frequency identification marker
Recommended times for verification of patient
identity
1.When the surgery is scheduled

2.When patient admitted to healthcare facility
3.Anytime patient transfered to other caregiver
4.Prior to sedation
5.Prior to patient entry into operating room
Shifting of patient to OT
The specific need of the patient should be considered
while selecting the method of transport.
 Need of IV poles
 Need to transport oxygen tank
 Mobility of the patient
 Conscious, semiconscious or unconscious patient
 Size of the patient
 Age of the patient
 Determining the physical abilities and state of health
of the patient
The following patient care concepts should be
implemented during the transfer of the patient
The individual who is transporting the patient

should introduce and identify to decrease the
anxiety of the patient
Correctly identify the patient to prevent wrong
surgery
If the patient is conscious explain the transfer
procedure prior to implementation to reduce the
anxiety and promote safety
Maintain the patients dignity during the transfer by
keeping him or her covered
To ensure the safety of the patient
• Elevate the side rails

• Apply safety straps
• Confirm IV lines, indwelling catheters,monitoring
system lines and drains and IV bag and collection
containers hanging away from the patients head
• Ensure head , arms and legs are protected
• The patient should be transported feet first
• Rapid movements should be avoided
• Staff at the patients head end
• Remain observant of the patient during transport
THANK YOU

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PRINCIPLES OF ANESTHESIA

The medication used to block pain are called

Anaesthesia temporarily block sensory or pain

Depending on the procedure and type of

 Local anaesthesia given to temporarily stop the

 GA affects the whole body,making patient

History and Physical Examination

If sponataneous ventilation is to be maintained

Difficulties and Complications

Monitoring should be started on the patient

Preoxygenation should be started using facemask

Induction can be done by IV induction agents

Regurgitation and vomiting

Should take into account surgical access, patient

The overall goal of maintenance phase of GA are

At the end of the surgery the muscle

Then patient is extubated after thorough

All patients undergoing surgical procedure should

1.When the surgery is scheduled

The individual who is transporting the patient

• Elevate the side rails

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