Wednesday, May 14, 2014

Review of Monitors and Monitoring During Sedation with Emphasis on Clinical Applications

Resident: Todd Bushman
Title: Review of Monitors and Monitoring During Sedation with Emphasis on Clinical Applications
Journal: Pediatric Dentistry 1995
Author: Stephen Wilson

Pulse Oximetry
-Continually measures indirectly O2 saturation and heart rate
-Sensor contains 2 elements: one emits light in red and infrared wavelengths and the other detects light transmission through tissue
-Oxygenated hemoglobin absorbs more red while deoxygenated hemoglobin absorbs more infrared wavelengths
-Signal errors may be caused by: crying, cold limbs, nail polishes, profound tissue pigmentation in some blacks

Blood Pressure Cuffs
-A combative or uncooperative child would be expected to have an elevated BP, which tends to decrease to normal values as the child becomes sedated
-In dosages designed to produce conscious sedation, most sedative agents do not cause significant clinical changes in BP

Capnography
-Measure expired CO2 concentrations with infrared absorption technology
-Normal CO2 concentrations in children range from 33-40mm Hg
-Most have an alarm to indicate an obstruction

Precordial Stethoscopes
-Can obtain heart, respiratory, GI, and joint sounds
-Placement of the stethoscope can cause breathing sounds or cardiac sounds to be predominant
-During sedations, airway sounds are more important

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